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Smith, Sarah Jane. "Metacognitive awareness of everyday memory in Parkinsons Disease." Thesis, University of Leeds, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522983.
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Pesola, Lauren E. "Parkinson's Disease: Are There Differences Among Measured & Perceived Function Between Stages of Disease." Bowling Green State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1408758404.
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Oliveira, Jussara Almeida de. "Validação da versão brasileira da Escala de Equilíbrio e Marcha (GABS) e análise do risco de quedas em indivíduos com doença de Parkinson e sujeitos saudáveis." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/17/17140/tde-18122014-101553/.
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Os estudos realizados até o momento demonstram que os instrumentos descritos na literatura possuem pouca capacidade de identificar os indivíduos em risco de quedas e portanto, existe a necessidade do desenvolvimento de novos testes ou de uma bateria de testes para essa população. Este estudo teve como objetivo traduzir e validar a Escala de Equilíbrio e Marcha (GABS) para aplicação em pacientes com doença de Parkinson (DP), determinar as características clínicas que estariam associadas ao maior risco de quedas em pacientes com DP e sujeitos saudáveis e analisar a utilidade do teste de Estabilidade Postural para avaliar o risco de quedas nos pacientes com DP. Foram selecionados pacientes do Ambulatório de Distúrbios do Movimento (AEXP) do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo, com diagnóstico de DP e controles saudáveis. Os participantes foram avaliados por meio da versão motora simplificada da UPDRS, escalas de HY, SE, FOGQ, FES-I, BBS e GABS. Fizeram parte do estudo 107 pacientes com DP e 80 controles e pode-se verificar que a versão brasileira da GABS mostrou ser válida e confiável, com ótima consistência interna e boa confiabilidade inter e intraexaminador. Além disso, obteve validade convergente consistente, com correlações boas com outros instrumentos que avaliam o mesmo conceito. Somado a esses resultados, a GABS teve boa acurácia, sensibilidade, especificidade, valor preditivo positivo e valor positivo negativo considerável. Quando a GABS foi comparada com a BBS, as duas escalas tiveram resultados semelhantes. Entretanto, a GABS mostrou ser uma escala mais completa que a BBS, pois avalia diversos aspectos relacionados ao risco de quedas, como a instabilidade postural, alterações na marcha, o freezing e o medo de quedas, mostrando ser um instrumento mais interessante de ser utilizado em futuros ensaios clínicos e estudos prospectivos de evolução clínica da doença. Com relação às quedas, o principal ambiente relacionado às quedas nos pacientes com DP foi o doméstico e a marcha a principal causa, já nos controles o principal local das quedas também foi o doméstico e a principal causa de quedas foram os obstáculos presentes no ambiente. Além disso, maior tempo de doença e maior medo de quedas foram os fatores que mais contribuíram para explicar as quedas da população com DP. O teste de Estabilidade Postural conseguiu diferenciar os indivíduos com DP que sofreram quedas dos que não sofreram quedas, obteve correlações significativas com outros instrumentos que avaliam o equilíbrio e teve boa confiabilidade interexaminador.Most studies to date have shown that the instruments available for the assessment of fall risk are inadequate for the identification of vulnerable individuals. Therefore, new tests assessing fall risk are strongly needed. This study aimed to translate and validate the Gait and Balance Scale (GABS) for use in patients with Parkinson\'s disease (PD), describe the clinical characteristics of a sample of patients with PD and controls that are related to the fall risk and analyze the Postural Stability test and it validity for assessing fall risk in patients with PD. We selected 107 PD patients at the Movement Disorders Outpatient Clinic of the School of Medicine of Ribeirão Preto - Universidade de São Paulo (USP) and 80 healthy controls. Participants were evaluated using the simplified version of the UPDRS motor scale, HY, SE, FOGQ, FES-I, BBS, and GABS. The Brazilian version of the GABS showed to be valid and reliable, with excellent internal consistency and good test-retest reliability. Furthermore, satisfactory convergent validity with other instruments that assess the same construct was found. In addition to these results, the GABS had good accuracy, sensitivity, specificity, positive predictive value, and negative predictive value. When the GABS was compared with the BBS, the two scales had similar results. However, the GABS showed to be more complete and could analyze more aspects related to fall risk in PD, as postural instability, gait deficits, freezing and fear of falling. Among controls, most falls also occurred indoors, however, they were mostly related to environmental hazards, and not gait. Longer disease duration and greater fear of falling were the factors that most contributed to explain falls in the population with PD. The Postural Stability test is able to differentiate individuals with PD who had experienced falls from those who had not, had significant correlation with others balance instruments and had good interexaminer reliability.
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Phillips, Kaitlyn, Brooks B. Pond, Hannah Oakes, and David R. McWethy. "The Influence of Long-Term Ritalin Exposure in a Female Model of Parkinson's Disease." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/asrf/2021/presentations/13.
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Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed disorder in children. Methylphenidate (MPH) or Ritalin, is a psychostimulant widely prescribed to treat ADHD from childhood to adulthood. Although patients take MPH for years, studies investigating long-term MPH use are lacking. Additionally, abuse of MPH is a growing problem in young adults. MPH blocks dopamine and norepinephrine transporters, which extends these neurotransmitters’ actions by preventing their reuptake from the cleft. Previous research has shown that long-term exposure to MPH causes dopamine-releasing neurons in the nigrostriatal pathway to become more susceptible to the Parkinsonian toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Here, the mechanism by which MPH sensitizes neurons to MPTP in a female model was investigated. The hypothesis was that oxidation of excess dopamine to a quinone causes neurons within this pathway to become more susceptible to MPTP. This dopamine quinone may be conjugated by the antioxidant glutathione (GSH); however, with an excess of dopamine and therefore quinones, GSH levels will become depleted. Without protection from GSH, quinones may lead to production of highly reactive free radicals, precipitating cell death. Estrogen is thought to be neuroprotective to MPTP, so it was further hypothesized that anestrus (low estrogen) females will show more dopamine cell loss, more quinone production, and more GSH depletion than proestrus (high estrogen) females. To test this hypothesis, MPTP-resistant adolescent female Swiss-Webster mice were divided into 3 treatment groups: saline (control), 1 mg/kg MPH (therapeutic dose), or 10 mg/kg (abusive dose). Within each group, mice were divided into proestrus and anestrus subgroups. All mice were injected twice daily with MPH or saline. After 12 weeks of injections followed by a 7 day washout period, half of each grouping received MPTP injections (4 x 20 mg/kg every 2 hours), while the other half received 4 injections of sterile saline. Mice were sacrificed either 3 or 7 days post-MPTP or saline injection. The substantia nigra and striatum of the nigrostriatal pathway that are affected by Parkinson’s disease were collected. Proestrus females in the saline group showed a significant (pmore dopamine quinone production (*p
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Maravic, Ksenija. "Risk Factors for Visual Hallucinations in Parkinsons Disease : Investigating the Continuum." Thesis, Oxford Brookes University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.506074.
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The present work presents a series of studies investigating neuropsychological aspects of visual hallucinations (VHs) in Parkinson's Disease (PD) and high proneness to VHs in the normal population. The aim of the thesis is to investigate whether the same risk factors are implicated in both hallucinating PD patients and in high-prone individuals from the normal population, i.e. the continuum hypothesis of VHs. To this end, new instruments were designed to assess the nature of VHs in PD and to differentiate among , high and low hallucination-prone individuals. PD patients with and without VHs, agematched normal controls, and high and low-prone normal young individuals are assessed on visual memory and executive tests from the CANTAB test battery, alongside tests examining personality factors, sleep patterns, and demographic factors. The findings suggest that VHs in PD and hallucination-proneness in the normal population are both associated with a combination of different factors, particularly aspects of visual processing and sleep patterns. Results from the five studies are interpreted with the multifactorial models of VHs, suggesting that both VHs in PD and hallucinationproneness in the normal population stem from concurrent neuropsychological dysfunctions of several processing systems. However, a specific personality profile is predictive of high hallucination-proneness in the normal population, but not in PD patients. Therefore, two different models are proposed, arguing for similar, but not identical set of risk factors in hallucinating PD patients and in high-prone normal individuals.
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Koduri, Balaram. "Quantitative Correlation Analysis of Motor and Dysphonia Features of Parkinsons Disease." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc801902/.
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The research reported here deals with the early characterization of Parkinson’s disease (PD), the second most common degenerative disease of the human motor system after Alzheimer’s. PD results from the death of dopaminergic neurons in the substantia nigra region of the brain. Its occurrence is highly correlated with the aging population whose numbers increase with the healthcare benefits of a longer life. Observation of motor control symptoms associated with PD, such as gait and speech analysis, is most often used to evaluate, detect, and diagnose PD. Since speech and some delicate motor functions have provided early detection signs of PD, reliable analysis of these features is a promising objective diagnostic technique for early intervention with any remedial measures. We implement and study here three PD diagnostic methods and their correlation between each other’s results and with the motor functions in subjects diagnosed with and without PD. One initial test documented well in the literature deals with feature analysis of voice during phonation to determine dysphonia measures. Features of the motor function of two fingers were extracted in tests titled “Motor function of alternating finger tapping on a computer keyboard” and “Motor function of the index and thumb finger tapping with an accelerometer”, that we objectively scripted. The voice dysphonia measures were extracted using various software packages like PRAAT, Wavesurfer, and Matlab. In the initial test, several robust feature selection algorithms were used to obtain an optimally selected subset of features. We were able to program distance classifiers, support vector machine (SVM), and hierarchical clustering discrimination approaches for the dichotomous identification of non-PD control subjects and people with Parkinson’s (PWP). Validation tests were implemented to verify the accuracy of the classification processes. We determined the extent of functional agreement between voice and motor functions by correlating test results.
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Pålhagen, Sven E. "Parkinson's disease and depression clinical and neurobiological studies /." Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-610-1/.
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Linse, Katharina. "Entwicklung und Evaluation einer psychoedukativ-kognitiven Gruppenintervention bei depressiven Symptomen bei Morbus Parkinson." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-219750.
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Hintergrund: Das idiopatische Parkinson-Syndrom (IPS) ist die zweithäufigste neurode-generative Erkrankung nach Morbus Alzheimer. Bei über 60-Jährigen liegt die Prävalenz bei bis zu zwei Prozent. Die somatischen Symptome verursachen vielfältige Beeinträchtigungen der Grob- und Feinmotorik und damit der Alltagsaktivitäten, viele Patienten leiden zusätzlich unter neuropsychiatrischen Symptomen. Das prominenteste neuropathologische Korrelat des IPS ist der Untergang dopaminerger Neurone in der Substantia Nigra. Dessen Ursachen sind nicht vollständig bekannt. Mit der Dopaminsubstitution steht eine erfolgreiche, jedoch nur symptomatische Therapie der chronisch progredienten Erkrankung zur Verfügung.
Epidemiologisch besteht ein bidirektionaler Zusammenhang zwischen dem IPS und depressiven Störungen. Bis zu 40% der IPS-Patienten leidet unter klinisch relevanten depressiven Symptomen (IPS-D). Einige von ihnen erfüllen nicht die gängigen Diagnosekriterien depressiver Störungen, leiden jedoch unter vergleichbaren Einschränkungen der Lebensqualität und des Funktionsniveaus. IPS-D ist ferner mit schnellerem Krankheitsprogress, höherer Angehörigenbelastung, Heimunterbringung und höheren sozioökonomischen Kosten assoziiert. In der Praxis ist von einer Untererkennung und -versorgung der IPS-D auszugehen. Die Spontanremissionsraten sind gering, auch bei Patienten unter antidepressiver medikamentöser Therapie bleibt häufig eine Restsymptomatik bestehen. Die pathogenetischen Mechanismen der IPS-D sind nur teilweise verstanden, es ist von einem komplexen Vulnerabilitäts-Stress-Modell mit neurobiologischen und psychosozialen Komponenten auszugehen. Ferner bestehen vermutlich Subtypen der IPS-D mit unterschiedlichen Ursachenkonstellationen und therapeutischen Bedürfnissen. Medikamentöse Interventionen sind weniger wirksam als bei primären depressiven Störungen. Psychosoziale Interventionen, speziell kognitive Verhaltenstherapie, sind ersten Studien zufolge eine vielversprechende Therapieoption. Die Zugangsbarrieren zu Psychotherapie sind jedoch relativ hoch.
Das Ziel der vorliegenden Arbeit war die Entwicklung einer niederschwelligen, speziell auf die IPS-D zugeschnittenen psychoedukativen Gruppenintervention. Hierfür wurde didaktisch und inhaltlich auf edukative Patientenprogramme zum IPS sowie Techniken der Psychoedukation und kognitiven Verhaltenstherapie als am besten beforschten Psychotherapieverfahren primärer depressiver Störungen zurückgegriffen. Es wurde eine multi-modale, ressourcenaktivierende, neunwöchige Intervention konzipiert, in deren Rahmen Informationen vermittelt und praktische Übungen zur Krankheitsbewältigung durchgeführt werden. In einem zweiten Schritt sollte Durchführbarkeit, Akzeptanz und subjektive Nützlichkeit sowie die Wirksamkeit der entwickelten Intervention auf die IPS-D an einer Patien-tenstichprobe evaluiert werden. Es wurde postuliert, dass sich die Intervention als gut durchführ bar erweist, von den Patienten gut angenommen wird und dass die fremd- und selbstgeratete Depressivität, das Belastungserleben und subjektive psychische Wohlbefinden durch die Intervention gebessert werden.
Forschungsmethoden: Zur Überprüfung der Hypothesen wurde eine unizentrische, raterverblindete Studie mit kontrollierter Randomisierung und Wartekontrollgruppe an einer Patientenstichprobe mit IPS-D durchgeführt. Es erfolgte eine randomisierte Zuweisung der Teilnehmer zu Kontroll- (KG) oder Interventionsgruppe (IG) nach entsprechend des Ergebnis der Montgomery-Åsberg Depression Rating Scale (MADRS) stratifizierten Paaren. Aufgrund von Rekrutierungsproblemen wurden Teilnehmer der KG später in die IG eingeschlossen. Insgesamt wurden 26 Patienten in die Studie eingeschlossen, fünf von ihnen brachen die Teilnahme ab oder wurden aufgrund von Verletzungen des Studienprotokolls ausgeschlossen, fünf nahmen sowohl an KG als auch IG teil. Somit konnten 26 Fälle unter Berücksichtigung der zweifach allokierten Patienten und 19 Patienten gemäß Studienprotokoll ausgewertet werden. Zur Evaluation des Programms kamen entsprechende Fragebögen zum Einsatz. Primäres Outcomemaß der Wirksamkeitsprüfung war die fremdgeratete Depressivität gemäß MADRS. Weiterhin wurden bei Studienbeginn, unmittelbar postinterventionell sowie nach weiteren sechs Monaten selbstgeratete Depressivität, Lebensqualität, Belastungserleben, subjektives Wohlbefinden, Funktionsniveau und somatische Parameter der Erkrankung erhoben. Zur Auswertung des mehrfaktoriellen Versuchsplans mit zwei Faktorstufen (Gruppen) und drei Messzeitpunkten mit abhängigen Stichproben und Stichprobenziehung mit Zurücklegen wurden unter anderem Varianzanalysen mit Messwiederholung und lineare kovarianzanalytische Modelle mit drei Prüffaktoren und Ausgangswertadjustierung erstellt.
Ergebnisse: Die Intervention erwies sich als gut durchführbar und wurde durch die Pati-enten gut akzeptiert. Die Rücklaufquote der Evaluationsfragebögen war mit 90% gut. Die meisten Patienten bewerteten das Programm als anschaulich und verständlich, die orga-nisatorischen Rahmenbedingungen als gut und die Inhalte als „hilfreich“. Insbesondere der Austausch mit Gleichbetroffenen wurde positiv bewertet. Es zeigte sich eine ausreichende Konzentrationsfähigkeit und bis auf wenige Ausnahmen ein gutes Verständnis der vermittelten Inhalte. In der per Protokoll analysierten Stichprobe konnten keine signifikanten Interventionseffekte nachgewiesen werden. Für die laut Studienprotokoll ausgewerteten ersten zwei Interventionsdurchgänge zeigte sich im Verglich mit der KG eine mit d=1,1 starke Reduktion der gesamten sowie der rein psychischen depressiven Symptomatik (Gesamtstichprobe: d=0,2 bzw. d=0,6), welche jedoch nur für die erstgenannte Teilstichprobe und nur unter Auslassung der somatischen Symptome statistische Signifikanz erreichte. Mit 38,5% erreichte ein nahezu signifikant größerer Teil der IG der Gesamtstichprobe Remission (p=0,063), bei 69,2% war die psychische Symptomatik mindestens um zwei Punkte gebessert, was als Minimum klinischer Relevanz gesehen wird. Die Effekte konnten über den Katamnesezeitraum nicht aufrechterhalten werden. In KG und IG kam es zu unterschiedlich starken Veränderungen der einzelnen depressiven Symptome mit einer stärkeren Reduktion von Traurigkeit, Untätigkeit und Suizidgedanken in der IG. Als Moderatorvariable der Treatmentresponse wurde lediglich die Teilnahme an einem der drei Interventions-Durchgänge identifiziert. Es konnten keine Interventionseffekte auf die wei-teren erhobenen psychischen Parameter erreicht werden.
Schlussfolgerungen: In Anbetracht der spärlichen Studienlage und des hohen Bedarfs hat diese Untersuchung einer niederschwelligen psychosozialen Intervention zur Besserung der IPS-D einen Beitrag zum Erkenntnisgewinn geleistet. Zum Zeitpunkt des Studienbeginns war noch keine, aktuell sind nur drei kontrollierte Studien dieser Art publiziert. Das untersuchte Gruppenprogramm hat sich als gut durchführbar und für die Patienten annehmbar und subjektiv hilfreich erwiesen. Leider konnten mit den gewählten Untersuchungsmethoden zusammenfassend keine signifikanten Interventionseffekte auf die IPS-D nachgewiesen werden. Dennoch wurde, je nach Analyseverfahren, eine mäßige bis starke Reduktion der depressiven Kernsymptomatik in der IG erreicht, welche im Vergleich zu anderen unkontrollierten und kontrollierten Studien im Gruppensetting als etwas gleichwertig einzuschätzen ist, im Vergleich zu Einzel-KVT jedoch als geringer. Es zeigte sich, dass die Gruppenzusammensetzung Auswirkungen auf den Erfolg der Intervention haben kann. Die Divergenz von fremdgerateter Depressivität, subjektiver Nützlichkeit und anderen Maßen psychischen Wohlbefindens weist darauf hin, dass durch die Intervention möglicherweise positive Veränderungsprozesse angestoßen, nicht aber abgeschlossen wurden. Die untersuchte Intervention kann nach leichter Modifizierung, insbesondere dem Einbezug von Angehörigen, eine hilfreiche Ergänzung im Behandlungsplan der IPS-D darstellen. Bei Persistenz der depressiven Symptomatik sollte jedoch individualisierte KVT und Pharmakotherapie zum Einsatz kommen. Es erscheint wichtig, ins Bewusstsein zu rücken, dass die IPS-D keine unabwendbare Begleiterscheinung des IPS sein muss. Neben weiterer Forschung zu psychosozialen Interventionen in verschiedenen Settings sollte die Abgrenzung verschiedener IPS-D-Subtypen mit Blick auf die Wahl verschiedener therapeutischer Strategien vorangetrieben werden. Dies gilt auch für die Wahl des optimalen Zeitpunktes, der Intensität und inhaltlichen Schwerpunktsetzung psychosozialer Interventionen wie der untersuchten.
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Zhao, Ming. "Neurorestorative strategies involving neurogenesis, neuronal precursors and stem cells in animal models of Parkinson's disease." Stockholm : Unit Injury and Repair in the Nervous System, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-649-1/.
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Delfani, Kioumars. "Neuronal dysfunction, death and repair in the MPTP model of Parkinson's disease /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-258-2.
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Kass-Iliyya, Lewis. "Pain in Parkinson's disease." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/pain-in-parkinsons-disease(2c746ce7-5ff0-4852-9a55-851ef0f5543c).html.
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Background: Pain is a very common symptom in Parkinson’s disease (PD). The underlying mechanism of pain in PD is poorly understood. Compared to PD, the characteristics of pain in other parkinsonian disorders such as Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) have not been studied. Musculoskeletal factors have been implicated in the generation of pain in PD. However, studies in PD have shown impaired central processing of nociceptive inputs. Recently, small fibre neuropathy has also been found to be common in PD with significantly reduced C-fibres density compared to controls. A subclass of C-fibres known as C tactile afferents (CT) mediate the pleasant sensation associated with gentle skin stroking (affective touch). CT afferents have recently been shown to have pain-inhibiting properties. These findings may implicate central sensitisation in pain generation in PD. Objectives: 1) To better understand the mechanisms of pain in PD and study the characteristics of pain in MSA and PSP compared to PD. 2) To quantify small fibre neuropathy in PD and explore its relation to pain utilising a novel diagnostic technique: corneal confocal microscopy (CCM). 3) To assess the perception of affective touch in PD and its relationship to pain. Methods: Four studies were conducted: Study 1: A cross sectional study of pain characteristics in PD, MSA and PSP. Study 2: A descriptive study of pain characteristics in a large cohort of early PD (disease duration < 3 years, n=1763). Study 3: A cross sectional study to quantify small fibre density in PD (n=26) compared to control subjects (n=26) using CCM and skin biopsies. Nerve density was correlated with non-motor symptoms in PD including pain. Study 4: A study to assess the CT-mediated perception of affective touch in PD and correlate it with clinical symptoms such as pain. Results: Study 1: Pain prevalence and intensity was significantly higher in MSA and PD compared to PSP, p < 0.05. Female sex and motor fluctuations but not motor severity were predictors for pain intensity in PD. Study 2: Pain was common in early PD (84.2%). Only a minority of PD patients (19.7%) reported that their pain improved with Levodopa therapy of their motor symptoms. Study 3: PD patients had significantly reduced small fiber nerve density on both CCM and skin biopsies compared to controls. Denervation correlated with autonomic symptoms but not with pain intensity. Study 4: Perception of pleasantness followed a linear relationship with nerve density and was abnormally enhanced in PD compared to control and correlated with pain at a very slow stroking velocity. Conclusions: Pain is common in early PD, does not respond to levodopa treatment and correlates with motor complications but not motor severity favouring central sensitisation. Pain is significantly less common in PSP compared to PD and MSA. Small fibre neuropathy does not appear to be an important cause of pain in PD but small fibre nerve density correlates with affective touch perception, which is enhanced in PD despite peripheral denervation. Corneal confocal microscopy identifies corneal denervation in PD offering a novel non-invasive way of assessing PD pathology.
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Kaur, Simranjit. "Investigation of the antiParkinsonian effects of glutamate antagonists in rodents." Thesis, University College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.267880.
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Åkerud, Peter. "GDNF family ligands and neural stem cells in Parkinson's disease /." Stockholm : [Karolinska Univ. Press], 2001. http://diss.kib.ki.se/2001/91-7349-042-3/.
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Little, Simon. "Adaptive deep brain stimulation for Parkinson's disease : closed loop stimulation for Parkinson's." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:5b76616a-7d5e-424e-9c66-5d48b19cae1c.
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Our understanding of the pathophysiology Parkinson’s disease has transformed over the last decade as we have come to appreciate the importance of changes in neuronal firing pattern that occur within the motor network in the dopamine deficient state. These changes in firing pattern, particularly increased synchrony result in oscillations that can be recorded as local field potentials. This thesis concerns itself with the study of beta oscillations which are characteristic of Parkinson’s disease. Firstly, I investigate whether beta oscillations play a pathophysiological role in Parkinson’s disease or whether they are purely epiphenomenal by augmenting beta with low frequency deep brain stimulation. In this study I show that rigidity is increased by ~25% with low frequency stimulation providing significant further evidence for a patho-physiological role of beta in Parkinson’s disease. Next I investigate whether beta oscillations correlate with Parkinsonian severity at rest and could therefore potentially be used as a biomarker of clinical state. I demonstrate that the variability of beta amplitude recorded from the subthalamic nucleus strongly correlates with symptom severity at rest and also in response to levodopa administration. I then use beta amplitude as a biomarker for a trial of adaptive deep brain stimulation in Parkinson’s disease. I show that by using beta amplitude to control stimulation, time on stimulation is reduced by >50% but despite this, clinical outcome is improved by 25% relative to conventional continuous high frequency stimulation. Finally, I investigate the bilateral subcortical beta network and its response to levodopa. I report statistically significant bilateral functional connectivity in the beta range which is driven by phase locking and modulated by levodopa in the low beta range with implications for bilateral adaptive deep brain stimulation. These findings further our understanding of the pathophysiological role of beta oscillations in Parkinson’s disease and provide new avenues for treatment development.
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Hatem, Ula, and Hiba Obed. "Oral hälsa hos individer med Parkinsons sjukdom : en litteraturöversikt." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Oral hälsa, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-40757.
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Bakgrund: Parkinsons sjukdom är en neurodegenerativ sjukdom som kan begränsa människan och minska dess förmåga att fungera normalt i det vardagliga livet. Bland individer diagnostiserade med Parkinsons sjukdom finns risk att munhälsan blir dåligt prioriterad. Till följd av detta tilltar behovet av andra människors hjälp samt lämplig tandvård. Syfte: Beskriva kunskapsläget avseende Parkinsons sjukdoms inverkan på förekomst av parodontala sjukdomar, karies, hyposalivation och xerostomi. Metod: Följande studie är en litteraturöversikt. Databaserna DOSS, MEDLINE och Pubmed användes för att svara på studiens syfte. Relevanta sökord samt inklusion- och exklutionskriterier användes för att finna väsentliga vetenskapliga artiklar som svarade på syftet. De vetenskapliga artiklarna blev kvalitetsgranskade med hjälp av en modifierad kvalitetsgranskningsmall. Resultat: Totalt inkluderades 19 vetenskapliga artiklar. Resultatet visade att individer med Parkinsons sjukdom har mindre bra oral hälsa. Flera av dessa studier visade på hög förekomst av parodontala sjukdomar. Resultatet visade även på hög förekomst av karies, hyposalivation samt xerostomi hos dessa individer. Slutsats: Individer med Parkinsons sjukdom löper större risk att drabbas av parodontala sjukdomar, karies, hyposalivation samt xerostomi. Dessa kan orsakas av olika faktorer så som medicinering, motoriska och icke-motoriska symtom samt sjukdomsdurationen.Bakground: Parkinson's disease is a neurodegenerative disease that may limit humans and reduce their ability for normal function in their daily life. Among individuals diagnosed with Parkinson's disease, there is a risk that oral health will be poor and not prioritized. As a consequence, the need of assistance and dental care increases. Aim: Describe the state of knowledge concerning the impact of Parkinson's disease on the incidence of periodontal disease, caries, hyposalivation and xerostomia. Method: The study design was a literature review. Scientific articles were searched in the databases DOSS, MEDLINE and Pubmed. Relevant keywords and inclusion and exclusion criteria were used to find essential scientific articles. The scientific articles were quality reviewed using a modified quality review template. Results: AA total of 19 scientific articles were included. The result showed that individuals with Parkinson’s disease have poor oral health. Several of these studies showed high prevalence of periodontal disease. The result also showed a high prevalence of caries, hyposalivation and xerostomia in these individuals. Conclusion: Individuals diagnosed with Parkinson's disease have an increased risk to develop periodontal diseases, caries, hyposalivation and xerostomia. These can be caused by different factors, medication, motor and non-motor symptoms and the disease duration.
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Alsén, Kim, and Marijana Lagundzija. "Ser du mig? : En litteraturstudie om upplevelsen av att leva med Parkinsons sjukdom utifrån teorin Preserving Self." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-39338.
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Parkinsons sjukdom är den näst vanligaste neurodegenerativa sjukdomen hos den äldre befolkningen. Sjukdomen påverkar den kroppsliga funktionen negativt på olika sätt och sjukdomens medicinering är betydelsefull för att kunna hantera de olika symtom som uppkommer. Personer med Parkinsons sjukdom lider risk för nedsatt livskvalitet på grund av den begränsning i livet som sjukdomen leder till. Syftet med denna studie var att belysa patientens upplevelse av att leva med Parkinsons sjukdom. Studien utfördes som en allmän litteraturstudie med en deduktiv ansats, där tio resultatartiklar användes. Resultatet kategoriserades och presenterades utifrån Preserving Self teorins fem steg och fyra övergångar. Teorin bidrog till ett brett och detaljerat resultat från resultatartiklarna och tillförde en fördjupad bild av livet med Parkinsons sjukdom. Sjuksköterskans ansvar innefattar att göra patienten delaktig i sin vård och ta tillvara de resurser som finns hos varje individ. Användningen av teorin Preserving Self kan bidra till fördjupad kunskap i vården för personer med Parkinsons sjukdom.Parkinson's disease is the second most common neurodegenerative disease in the elderly population. The disease adversely affects the bodily function in various ways and the medication of the disease is important in order to handle the various symptoms that arise. People with Parkinson's disease are at risk of impaired quality of life due to the limitations in life that the disease causes. The purpose with this study was to highlight the patient's experience of living with Parkinson's disease. The study was conducted as a general literature study with a deductive approach, in which ten result articles were used. The result was categorized and presented based on the five stages and four transitions in the theory of Preserving Self. The theory contributed to a broad and detailed result from the resultarticles and added an in-depth picture of life with Parkinson's disease. The nurses’ responsibility includes getting the patient to participate in their care and taking advantage of the resources that exist in each individual. Using the theory of Preserving Self can contribute to in-depth knowledge in the care for people with Parkinson's disease.
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Johansson, Inga-Lena. "Aktiviteter och upplevelse av delaktighet hos personer med Parkinsons sjukdom." Thesis, Mälardalen University, Department of Social Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-476.
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Parkinsons sjukdom är en neurologisk sjukdom, som främst drabbar motorik, men även kan påverka psykosociala och kognitiva funktioner. Studiens syfte var att kartlägga aktiviteter och upplevd delaktighet hos en grupp personer med Parkinsons sjukdom (n = 10). En semistrukturerad intervju gjordes med genomgång av aktiviteter under ett dygn. Data analyserades utifrån aktivitets- och delaktighetsdomänerna i ICF. Jämförelse med tidigare forskningsresultat visade att personerna i den aktuella undersökningsgruppen ägnade mer tid åt personlig vård, men mindre tid åt vila och TV-tittande. Upplevd delaktighet i aktiviteterna skattades generellt som hög, men en negativ korrelation sågs mellan tid sedan diagnos och delaktighet inom domänen Viktiga livsområden. En stor spridning i materialet indikerar att exempelvis rehabiliteringsinsatser bör baseras på individuell aktivitetsanalys.
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Chan, Daniel Kam Yin School of Physiology & Pharmacology UNSW. "Genetic and environmental risk factors for Parkinson's disease in Chinese and Australians." Awarded by:University of New South Wales. School of Physiology & Pharmacology, 2000. http://handle.unsw.edu.au/1959.4/17795.
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The aim of this work was to study the environmental and genetic factors for Parkinson???s disease (PD) in Chinese and Australian. Using a case-control method, environmental factors for PD were studied in a Chinese population (n=528) in Hong Kong. Current smoking (OR=0.437; p=0.013) and infrequent tea drinking (OR=1.51; p=0.02) were found to be protective factors, whereas family history and pesticide exposure during farming in females were found to be risk factors in the univariate analysis. In the multivariate analysis, current smoking reached borderline significance at the 5% level and the variables, years exposed to pesticides and family history were significant at the 10% level. Similarly, a case-control study involving 534 subjects was conducted in Australia. A positive family history was the strongest risk factor (OR=3.4; p<0.001). In addition, rural residency was found to be another risk factor (OR=1.8; p<0.001). Hypertension, stroke and well water ingestion were inversely correlated with PD (OR=0.2; p<0.001, OR=0.2; p<0.001 and OR=0.7; p<0.03 respectively). When genetic factors were examined in the Chinese population, no association to PD were found for the polymorphisms of the following candidate genes: CYP-2D6 debrisoquine hydroxyalse gene, dopamine transporter gene and monamine oxidase B (MAOB) gene. Furthermore, the Ala53Thr and Ala30Pro mutations of the alpha-synuclein gene were not found amongst this large Chinese population, indicating that variations of this gene are probably rare in Chinese. When candidate genes were studied amongst Caucasian Australians, the poor metaboliser genotype of CYP-2D6 was found to be weaky associated with PD (OR=1.36) in a meta-analysis. The length of the GT repeat alleles of MAOB gene were found to be significantly associated with PD (>188 base pair and 186 base pair) while angiotensin converting enzyme gene polymorphism was not found to be associated with PD. A pilot study was then conducted in Randwick, New South Wales to find out the latest prevalence of PD as well as putative risk factors in a random population. A validation study was carried out for a screening tool (questionnaire) for PD, which was then used for the main study. A total of 730 subjects were involved (527 in the community and 203 in institutions). The survey found that PD prevalence was between 3.6% and 4.9% (higher in aged care facilities). The putative risk factors positively identified were ???family history???(p<0.01) and ???exposure to chemicals at work or in surrounding environment??? (p<0.05). The age adjusted prevalence rate of PD revealed at least 42.5 % increase in the disease compared to 1966. We conclude that there may be an increase in the disease in Australia due to aging and other risk factors.
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Nilsson, Tobias, and Maria Stenström. "GÅNGPROBLEMATIK HOS PERSONER MED PARKINSONS SJUKDOM -EN LITTERATURSTUDIE." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26639.
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Gångproblematiken hos personer med Parkinsons sjukdom är svårhanterad av både vårdtagare och vårdare och kräver mycket kunskap och förståelse. Syftet med denna litteraturstudie var att identifiera omvårdnadsåtgärder som kan underlätta gångproblematik hos personer med Parkinsons sjukdom. Tio kvantitativa studier har används i denna litteraturstudie och sökningar har gjorts i Pubmed och i CINAHL. Resultatet från dessa sökningar presenterades i fyra strategier och fynden var rehabilitering, individanpassad träning, stimuli och användandet av dagböcker. Dessa strategier kan användas som verktyg för en sjuksköterska när hon interagerar med personer med Parkinsons sjukdom. Genom en ökad insikt i hur det går att underlätta den specifika gångproblematiken kan omvårdnaden optimeras.Gait disturbance in persons with Parkinson’s disease is difficult to manage by both caretakers and caregivers and it requires much knowledge and understanding. The aim of this literature review was to identify means to aid the gait disturbance in persons with Parkinson’s disease. Ten quantitative studies have been used in this literature review and searches were carried out in Pubmed and CINAHL. The results from these searches were presented in four strategies and the findings were rehabilitation, individual exercise schedules, cueing and the use of diaries. These strategies can be used by a nurse as tools while she is interacting with persons with Parkinson’s disease. With a greater insight on the specific gait disturbances nursing can be optimized.
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Pham, Thu-Trang. "Functional analysis of DJ-1 deficient mice - a mouse model for Parkinsons disease." Thesis, Open University, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504328.
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Larsson, Elias, and Fredrik Isaksson. "Avgörande faktorer för talnaturlighet hos personer med Parkinsons sjukdom : Korrelationsstudie mellan naiva lyssnares bedömning och akustisk analys." Thesis, Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-118886.
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Tal- och röstförändringar är vanligt förekommande hos personer med Parkinsons sjukdom. Dessa påverkar ofta talarens förståelighet men kan också ha en negativ inverkan på talets naturlighet. Forskning angående vilka faktorer som påverkar talets naturlighet är i dagsläget begränsad, varför föreliggande studie har genomförts. Syftet med studien var att undersöka huruvida den uppfattade talnaturligheten kunde härledas till några specifika tal- och röstparametrar. I föreliggande studie konstruerades ett testbatteri för att elicitera talmaterial från åtta personer med Parkinsons sjukdom. Forskningspersonernas röster spelades in och inspelningarna graderades sedan av 27 naiva lyssnare gällande förståelighet och talnaturlighet. Korrelationstester genomfördes slutligen för att hitta eventuella samband mellan lyssnarnas bedömning och olika akustiska parametrar. Resultatet visade att tal- och artikulationshastighet var den faktor med störst inverkan på lyssnargruppens bedömning av talnaturlighet, där de med långsammast hastighet bedömdes ha mest onaturligt tal. Vidare fanns starka indikationer på att grad av förståelighet korrelerade med bedömningen av talnaturlighet. I föreliggande studie tycktes inga övriga akustiska parametrar ha en statistiskt signifikant korrelation med lyssnargruppens bedömning av talnaturlighet.Speech and voice changes are common in Parkinson’s disease. These changes can affect the speaker’s intelligibility but can also have a negative impact on the perceived naturalness of speech. The research available regarding the different factors that affect speech naturalness is scarce, which was the motivation behind this study. The aim of the present study was to investigate whether the level of perceived speech naturalness could derive from any specific aspects of speech. This was accomplished by recording speech samples from eight people with Parkinson’s disease using a test battery with various speech tasks. These samples were presented to a group of 27 naive listeners whose task was to judge the level of intelligibility as well as the level of speech naturalness. Correlations were then made between their assessments and various acoustic measurements. The main finding of the present study was that speech and articulation rate seemed to have the greatest impact on the perceived level of naturalness, where the people who had the slowest rate were judged to be the least natural sounding. Furthermore there were strong indications that the level of intelligibility correlated with the level of speech naturalness. In this study there were no other acoustic correlates found with statistical significance.
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Buervenich, Silvia. "Candidate genes and the dopamine system : possible implications in complex neurological and psychiatric disease /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-202-7.
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Diniz, Karen Rafaella da Silva. "Investigação de mutações no gene ATP13A2 como um fator de risco para a Doença de Parkinson em pacientes brasileiros." Universidade do Estado do Rio de Janeiro, 2010. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=4576.
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Conselho Nacional de Desenvolvimento Científico e TecnológicoA doença de Parkinson (DP) é a desordem neurodegenerativa motora mais frequente, com uma prevalência de, aproximadamente, 1% entre indivíduos com mais de 60 anos de idade, aumentando para 4 a 5% entre os indivíduos com idade superior a 85 anos. Esta condição é caracterizada pela perda seletiva dos neurônios dopaminérgicos da substância negra e pela presença de inclusões protéicas ricas em α-sinucleína nos neurônios sobreviventes. Pouco se sabe sobre a etiologia e a patogênese da DP. A maioria dos casos aparece esporadicamente, podendo estar associados a diversos fatores de risco ambientais e genéticos. Na última década, estudos de ligação identificaram 15 loci cromossômicos (PARK1 a PARK15) relacionados à DP e, nestes, um novo gene, ATP13A2, tem sido associado a casos de DP de início precoce. Esse gene está situado no 1p36 e codifica a proteína ATPase tipo-P da subfamília P5, de localização lisossômica, que é expressa em diversos tecidos, principalmente no cérebro. Mutações em ATP13A2 levam à formação de proteínas truncadas que ficam retidas no reticulo endoplasmático e posteriormente são degradadas pelo proteossomo, podendo causar a disfunção proteossômica, decorrente da sobrecarga gerada pela proteína mutante, ou causar a disfunção lisossômica, ambas gerando agregação tóxica. Este trabalho tem como objetivo realizar a análise molecular do gene ATP13A2 em uma amostra de 116 pacientes brasileiros com DP, de manifestação precoce (<50 anos), de forma a avaliar se mutações neste gene representam um fator de risco para a DP. O DNA foi extraído a partir de leucócitos do sangue periférico ou de saliva e a análise molecular dos éxons 2, 3, 12, 13, 14, 15, 16, 26 e 27, bem como, dos limites íntronéxons foi realizada por sequenciamento automático dos produtos da PCR. Identificamos oito variantes de sequência: quatro variantes intrônicas (uma no íntron 2, uma no íntron 13 e duas no íntron 27) e quatro variantes silenciosas (uma no éxon 3, 16, 26 e 27). Com base em dados da literatura e através de análises in silico e comparação com amostras controle, classificamos a alteração intrônica c.3084- 3C>T, e as alterações silenciosas c.2970G>A e c.3192C>T como não patogênicas; as alterações intrônicas c.106-30G>T, c.1306+42_1306+43 insC e c.3083+24C>T, e as alterações silenciosas c.132A>G e c.1610G>T foram classificadas como provavelmente não patogênicas. Nosso achados corroboram àqueles encontrados em outras populações e indicam que mutações no gene ATP13A2 não são uma causa comum de DP na amostra de pacientes brasileiros analisados. No entanto, se faz necessário estender nossas análises para outras regiões gênicas, a fim de determinar o real papel deste gene na etiologia da DP em nossa população.
Parkinson's disease (PD) is the most common neurodegenerative movement disorder with a prevalence of, aproximately, 1% among individuals older than 60 years, increasing to 4% or 5% among individuals older than 85 years. This condition is characterized by selective loss of dopaminergic neurons and the presence of protein inclusions rich in α-sinuclein in the survivors neurons. Little is known about the etiology and pathogenesis of PD. Most cases appear sporadically and may be associated with various environmental and genetic risk factors. In the last decade, linkage studies have identified 15 chromosomal loci (PARK1 the PARK15) related to PD and ATP13A2 is one of the most recent genes associated with cases of early onset PD. The ATP13A2 gene is located at 1p36 and encodes the ATPase protein (Ptype of P5 family) located in lysosome which is expressed in different tissues, especially in brain. Mutations in this gene lead to the formation of truncated proteins that are retained in the endoplasmic reticulum and are subsequently degraded by the proteosome. This may cause proteosomal dysfunction, resulting from the overload generated by the mutant protein, or can cause lysosomal dysfunction, both generating toxic aggregation. This study aims to perform molecular analysis of ATP13A2 gene in a sample of 116 Brazilian patients with early onset PD (<50 years), to assess whether mutations in this gene represent a risk factor for PD. The DNA was extracted from peripheral blood or saliva and molecular analysis of exons 2, 3, 12, 13, 14, 15, 16, 26 and 27 was conducted by direct sequencing of PCR products. In this study we identified eight sequence variants in ATP13A2 gene: four intronic variants (one in intron 2, one in intron 13 and two in intron 27) and four silent variant (exon 3, 16, 26 and 27). Based on literature data and the results obtained from in silico analysis and studies of control samples, we classified the intronic alteration c.3084-3C>T and the silent variants c.2970G>A and c.3192C>T as non-pathogenic; the intronic alterations c.106-30G>T, c.1306+42_1306+43 insC e c.3083+24C>T and the silent variants c.132A>G e c.1610G> as probably non-pathogenic. The data obtained in our study corroborate those found in other populations and show that mutations in the ATP13A2 are not a common cause of PD in the sample of Brazilian patients analysed. However, it is essential to extend our analysis to other gene regions in order to determine the actual role of this gene in the etiology of PD in our population.
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Homem, Karen Silvia de Carvalho. "Liberação de 3H-GABA por tecido estriatal de ratos: caracterização e efeitos da lesão experimental parkinsoniana." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-08102013-153353/.
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A Doença de Parkinson, uma condição neurodegenerativa e progressiva, está relacionada à morte de neurônios localizados na Substância Negra compacta, um dos componentes dos Núcleos da Base. Quando há a morte de neurônios dopaminérgicos nigrais, esta via modulatória é perdida, levando ao desequilíbrio entre as vias direta e indireta, esta última tendo sua atividade aumentada em detrimento da outra. O estriado tem um papel importante no recebimento e filtração de sinais motores corticais e talâmicos e suas maiores populações neuronais são GABAérgicas, demonstrando a importância do neurotransmissor GABA nesta modulação. O estriado recebe projeções dopaminérgicas vindas da Substância Negra compacta e, na falta desta aferentação, surgem os sintomas e sinais da Doença de Parkinson. Nosso objetivo é caracterizar a liberação de GABA nesta estrutura, avaliando os efeitos de outros transmissores e também o papel de alguns sinalizadores intracelulares neste processo. Para isto, empregamos o método de superfusão e liberação de GABA radiomarcado, previamente carregado, em tecido picado in vitro. A lesão nigral é produzida por cirurgia estereotáxica e microinjeção de 6-OHDA no feixe medial prosencefálico (mfb). Diversas drogas foram utilizadas para avaliarmos diferentes passos na liberação do transmissor. Concluímos que a liberação é fortemente dependente de cálcio e segue o modelo de exocitose vesicular, além de a subpopulação neuronal GABAérgica estrital estudada sofrer pouca influência de aferências glutamatérgicas e colinérgicas. No entanto, drogas dopaminérgicas regulam complexamente a liberação de GABA no estriado e ela também é bastante dependente de calmodulina. Conjecturamos se algumas drogas antipsicóticas que agem sobre calmodulina devem seu efeito terapêutico, ou parte dele, a esta ação e se, no modelo de DP de lesão unilateral por 6-OHDA, há comunicação entre os hemisférios lesado e não lesado após o estabelecimento da lesão e processo de rearranjo neuronalParkinsons disease, a progressive and neurodegenerative condition, is related to the death of neurons located in Substantia Nigra compacta, a component of Basal Ganglia. When nigral dopaminergic neurons die, this modulatory pathway is lost leading to imbalance between direct and indirect pathways, the latter having its activity increased over the former. Striatum has an essential role in receiving and filtering motor signals from cortex and thalamus and its major neuronal populations are composed by GABAergic neurons, showing how important is GABA in this modulation. Striatum receives dopaminergic projections from Substantia Nigra compacta and in its absence the typical signals and symptoms of the disease arise. We aimed to characterize GABA relase at this structure, assessing the effect of other transmitters as well the role of some intracellular signaling molecules in this process. For that, we employed the superfusion method and release of preloaded radiolabeled GABA from chopped striatal tissue. Nigral injury was produced by stereotaxic surgery and 6-OHDA microinjection at medial forebrain bundle (mfb). Several drugs were used to evaluate different steps in transmitter release. We concluded that the release is strongly calcium-dependent and follows vesicular exocytosis model; in addition the striatal GABAergic subpopulation of neurons studied here undergo little influence of glutamatergic and cholinergic afferents. However, dopaminergic drugs complexly regulate striatal GABA release and it also shows high involvement of calmodulin. We wonder if some antipsychotic drugs that act over calmodulin owe their therapeutical effects, or at least part of it, to this activity and if in 6-OHDA unilateral lesion parkinsonism model there is communication between injuried and healthy hemispheres after the establishment of the injury and neuronal rearrangement process
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Sunvisson, Helena. "The embodied experience of living with Parkinson's disease /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-570-0/.
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Gyrling, Therese, and Magnus Ljunggren. "Dansens påverkan på den psykiska hälsan hos individer med Parkinsons sjukdom." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-36822.
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I Sverige beräknas ca 18000-20000 individerha Parkinsons sjukdom (PS) och de flesta som drabbas är över 65 år. PS associeras med motoriska och icke-motoriska symtom som alla påverkar livskvaliteten hos de drabbade. För att minska psykisk ohälsa och öka livskvaliteten behöver man identifiera alternativa, ej farmakologiska behandlingar vid PS samt förebygga depression. Syftet var att undersöka hur dans påverkar den psykiska hälsan hos individer med PS. Kvalitativ metod med semistrukturerade intervjuer användes. Tio informanter med variation i hur länge de har haft sjukdomen, ålder och kön intervjuades. Resultatet visar att dansen gav individerna glädje, gjorde att de kände sig som en del av något större och gav dem ökad självkänsla. Studien visar på dansens betydelse för den psykiska hälsan hos individer med PS. Det är viktigt att undersöka alternativa behandlingsmetoder vid PS för att minska den psykiska ohälsan, läkemedelsanvändningen samt öka livskvaliteten.In Sweden, approximately 18000-20000 individuals are expected to have Parkinson's disease (PD) and the individuals affected are mostly over 65 years old. PS is associated with motor and non-motor symptoms that all affects the quality of life of the individuals. In order to reduce mental illness and increase quality of life, alternative, non-pharmacological treatments of PD, and prevention of depression need to be identified. The aim of the study was to investigate how dance affects the mental health of people with PD. Qualitative method and semi-structured interviews was used. Ten informants with variation of how long they have had the disease, age and gender were interviewed. The result shows that the dance gave the individuals joy, made them feel part of something bigger and gave them greater self-esteem. The study shows the importance of dance for the life situation and mental health of people with PD. It is important to investigate alternative treatment methods in PD to reduce mental illness, drug use and increase quality of life.
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Skansen, Erica. "Cueingstrategiers effekt på freezing och gånghastighet vid Parkinsons sjukdom : En litteraturöversikt." Thesis, Uppsala universitet, Sjukgymnastik, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200426.
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Parkinsons sjukdom drabbar 15 av 10 000 personer. Sjukdomen kan påverka gången genom freezing, då individen stannar upp och är oförmögen att fortsätta att gå. Detta är ett mycket besvärande symtom som kan behandlas med olika cueingstrategier. Även gånghastighet kan förbättras med hjälp av cueingstrategier. I den senaste litteraturstudien var evidensen för cueing oenig. Syftet med litteraturöversikten var att undersöka om evidensen för auditiv och visuell cueings effekt på freezing och gånghastighet har stärkts sedan den senaste litteraturstudiens kartläggning. En deskriptiv design valdes för litteraturöversikten. Sju artiklar från databaserna PubMed, Amed, PEDro och Cinahl uppfyllde inklusionskrierierna och granskades enligt PEDro scale. Auditiva och visuella cueingstrategier minskade freezing och hade varierande effekt på gånghastighet. Flera studier kombinerade båda cueingstrategierna tillsammans eller med annan träning. Vidare studier där enbart en cueingstrategi används behöver göras för att fastställa vilken cueingstrategi som ger vilken effekt.Parkinson’s disease affects 15 of 10 000 people. The disease can affect gait through freezing, which is when the individual stagnates, unable to continue walking. This disabling symptom can be managed with cueing strategies. Gait speed can also improve with cueing. The latest literature review that examined cueing showed disagreeing results. The aim of this literature review was to investigate if the evidence for the effect of auditory and visual cueing on freezing and gait speed has improved since the latest review. A descriptive design was chosen. Seven articles from the databases PubMed, Amed, PEDro and Cinahl met the inclusion criteria and were analyzed with PEDro scale. Auditory and visual cueing decreased freezing and showed varying results on gait speed. Several studies combined both cueing strategies with each other and other training. Future research that only uses one cueing strategy is needed to determine the effects of each strategy.
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Gustavsson, Emelie, and David Löfström. "Livskvalité vid Parkinsons sjukdom : En allmän litteraturstudie." Thesis, Röda Korsets Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2530.
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Bakgrund: Parkinsons sjukdom är en kronisk progredierande neurodegenerativ sjukdom och är den näst största i dess slag. Sjukdomen kan ge uttryck i både motoriska och icke-motoriska symtom. Genom sjukdomsförloppet genomgår personen olika faser som medför förlust av både mentala och kroppsliga funktioner. Förlusten av funktionerna ger en generellt sämre livskvalitet än hos andra personer. Syfte: Syftet med litteraturöversikten var att belysa symtomens påverkan på livskvaliteten hos personer med Parkinsons sjukdom. Metod: En allmän litteraturstudie baserad på tio kvalitativa studier. Resultat: Resultatet visar på att personer som lever med Parkinsons sjukdom har en komplex livssituation. De fysiska symtom som sjukdomen kännetecknas av ger svårigheter i vardagen. Resultatet visar också att den psykiska hälsan blir väsentligt påverkad i samband med detta. En följd av de fysiska och psykiska symtomen kan leda till social isolering, och tillsammans kan dessa skapa en kedjereaktion som leder till en försämrad livskvalitet. Slutsats och förslag på forskning: De motoriska symtomen är det mest påfrestande med att leva med Parkinsons sjukdom och bidrar starkt till en minskad livskvalitet. Därför behövs vidare omvårdnadsforskning för personer med Parkinsons sjukdom samt vilka omvårdnadsåtgärder som skulle kunna leda till förbättrad livskvalitet.Background: Parkinson's disease is a chronic progressive neurodegenerative disease and is the second largest of its kind. The disease expresses both motor and non-motor symptoms. Through the course of the disease, the person undergoes different phases that cause loss of both mental and physical functions. The loss of functions gives a generally poorer quality of life than other people. Aim: The aim of the literature review was to highlight the effects of the symptoms on quality of life for people with Parkinson's disease. Method: A general literature study based on ten qualitative studies. Result: The result shows that people who are living with Parkinson's disease, lives in a complex life situation. The physical symptoms that the disease is characterized by creates difficulties in everyday life. The result also shows that mental health is significantly affected in this regard. A consequence of the physical and mental symptoms can lead to social isolation, and together they can create a chain reaction that leads to a deteriorating quality of life. Conclusion and Suggestions for Research: The motor symptoms are the most profound of living with Parkinson's disease and contribute significantly to a reduced quality of life. Therefore, nursing research is needed for people with Parkinson's disease as well as nursing measures that could lead to improved quality of life.
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Wirdefeldt, Karin. "Studies of genetic and environmental influences on Parkinson's disease /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-771-1/.
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Karlström, Petra, and Linda Mårtensson. "Parkinsons sjukdom och livskvalitet - en kvalitativ litteraturstudie utifrån parkinsonsjuka personers upplevelser av livskvalitet." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24613.
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Karlström, P & Mårtensson, L. Sjukdomen Parkinson och livskvalitet. En kvalitativ studie utifrån Parkinsonsjuka personers upplevelser av livskvalitet. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Högskola: Fakulteten för Hälsa och Samhälle, Utbildningsområde omvårdnad, 2016. Parkinsons sjukdom är en kronisk progressiv neurologiskt sjukdom. Orsaken till sjukdomen är okänd. Årligen insjuknar omkring 2000 personer i Sverige. Prevalensen i Sverige uppskattas till 20 000 fall. Medelåldern vid symtomdebut är 55 år. De tre kardinalsymtomen är rörelsehämning, skakning och muskelstelhet. Ofta finns också psykiska symtom så som depression, ångest och initiativlöshet. Parkinsons sjukdom påverkar den drabbade personens dagliga liv och livskvalitet.Syftet med studien var att undersöka hur vuxna personer som lever med Parkinsons sjukdom upplevde sitt dagliga liv samt deras beskrivning av hur livskvaliteten påverkades. Metoden var en litteraturstudie för att sammanställa tidigare vetenskaplig forskning av kvalitativ ansats. Databasökning utfördes i tre olika databaser. De aktuella artiklarna värderades kritisk utifrån granskningsprotokoll. Resultatet baserades på tio kvalitativa artiklar. Slutresultatet delades in fyra huvudkategorier med underkategorier där fynden presenteras. Huvudkategorierna var Relationer och social samvaro, Hälsa och ohälsa, Kroppsliga förändringar samt Leva vidare trots sjukdomen Parkinson. Konklusion är att Parkinsons sjukdom är en komplicerad sjukdom som påverkar patientens liv och livskvalitet. Nyckelord: Acceptans, , Framtid, Livskvalitet, Parkinsons sjukdom och Socialt, VälmåendeKarlström, P & Mårtensson, L. Parkinson`s Disease and Quality of Life - An qualitative literature review from the perspective of the patients with Parkinson`s Disease about Quality of life. A literature review. Degree project in Nursing science, 15 Credit Points. Malmö University. Faculty of Health and Society. Department of Caring Science, 2016.Parkinson`s Disease is a progressive neurological disease. The cause of the disease is still unknown. In Sweden, there are 2000 new sufferers each year. The prevalence in Sweden is about 20 000. The average age due to the first symtoms appearing, is 55 years old. The three main symtoms are: akinesia, shakiness and muscle stifness. The disease also includes symtoms as depression, anxiety and apathy. Parkinson`s Disease has an effect on many aspects of life. The aim of the study was to examine how grown adults experienced their daily life and how they described the Quality of life changing. The method was a literature review using qualitative data. Data was gathered from three different databases. The material was then critically evaluated using a qualityprotocall.The results were gathered from ten different articles. Four main qualitative categories were found: Relations and socializing and Health and ill-health, body changes and Live on despite having Parkinson`s Disease. The main categories were later on further divided into subcategories. Conclusions that was drawn explained that Parkinson`s disease is a complicated disease envolving many aspects of the patients life which contributes to the experience of Ouality of life. Keywords: Acceptance, Future, Parkinson`s Disease and Socially wellbeing. Quality of life.
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Hirayama, Marcio Sussumu [UNESP]. "Atividade física e doença de Parkinson: mudança de comportamento, auto-eficácia e barreiras percebidas." Universidade Estadual Paulista (UNESP), 2006. http://hdl.handle.net/11449/87372.
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hirayama_ms_me_rcla.pdf: 801369 bytes, checksum: 14d1b0e38175ba20415e46ef5c61c878 (MD5)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
A população com doença de Parkinson (DP) convive com um distúrbio neurodegenerativo, crônico e progressivo que mesmo com uma terapia farmacológica ótima, não vê cessar o seu agravamento. A prática de atividades físicas (AF) é uma medida sustentável necessária para atingir os objetivos do seu tratamento, e atender as demandas atuais da saúde pública. O hábito de praticar atividade física é melhor abordada por meio de modelos teóricos da mudança do comportamento. O presente estudo objetivou analisar os fatores associados à prática de atividades físicas em parkinsonianos, utilizando o Modelo Transteorético e a Teoria Cognitivo-Social. A pesquisa foi de delineamento transversal do tipo descritivo correlacional. Participaram do estudo 65 indivíduos (de ambos os gêneros; com 66 l 9 anos de idade) diagnosticados com DP, vinculados aos serviços de saúde do município de Rio Claro e região ou à Associação Brasil-Parkinson situada na cidade de São Paulo. Foi utilizado um questionário composto por: dados pessoais, nível da gravidade da doença, estágios de mudança do comportamento, auto-eficácia, preferências em relação à prática de atividade física e barreiras percebidas. A interpretação dos resultados permitiu concluir que as variáveis da teoria cognitivo-social (auto-eficácia e percepção de barreiras) são potenciais mediadores da prática de AF em parkinsonianos. Além disso, eles já mantêm ou cogitam praticar AF regularmente; estão em média confiantes que podem superar algumas barreiras; percebem barreiras principalmente no domínio físico (bradicinesias, perda do equilíbrio, acinesias, rigidez muscular, ter uma doença, tremores, medo de cair), seguido pelo domínio da motivação (preguiça) e domínio ambiental (falta de companhia, clima ruim); seus tipos de AF preferidas são a caminhada...
The population with Parkinson's disease (PD) faces a neurodegenerative, chronic and progressive disturbance, which even under an optimum pharmacological therapy it does not cease its aggravation. The practice of physical activities (PA) is a necessary and sustainable strategy that contributes for attaining both the treatment goals, and meeting the current demands of the public health. The habit of exercising is better approached by behavior change theoretical models. The present study aims to analyze the correlates of PA practice in Parkinson's disease patients, based on the Transtheoretical Model and the Social Cognitive Theory. It was a cross-sectional and descriptivecorrelational research design. Sixty-five individuals (both gender; 66 l 9 yearold) with diagnosis of PD; under medical treatment; living at Rio Claro or São Paulo city and their surrounding areas and; being affiliated or not to Brazil-Parkinson Association. A questionnaire comprising personal data, disease severity level, behavior change stage, self-efficacy, preferences and perceived barriers regarding the practice of PA, was applied. Data were analyzed by means of descriptive statistics and mostly by the Spearman correlation test. The results interpretation allowed concluding that the Social Cognitive Theory variables (self-efficacy and perceived barriers) are potential mediators of PA in Parkinson's disease patients. Besides, they are already intending to or actually practicing PA on a regular basis; on average, they are confident that they are able to overcome some barriers; they perceive barriers mainly those in the physical domain ( bradikinesias, balance loss, akinesias, muscular rigidity, have a disease, tremors, fear of falling), followed by those in the motivation domain (laziness) and third, those in the environmental domain... (Complete abstract, click electronic access below)
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Abreu, Gabriella de Medeiros. "Investigação de variantes exônicas nos genes VPS35, EIF4G1 e LRRK2 como causa da doença de Parkinson em casuística brasileira." Universidade do Estado do Rio de Janeiro, 2015. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8633.
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Conselho Nacional de Desenvolvimento Científico e TecnológicoA doença de Parkinson (DP) é a segunda doença neurodegenerativa mais frequente no mundo, afetando 1-2% da população acima de 65 anos, caracterizada clinicamente por tremor em repouso, bradicinesia, instabilidade postural e rigidez muscular. Essas manifestações surgem devido à degeneração neuronal progressiva e à presença de inclusões proteicas ricas em α-sinucleína. A DP é decorrente da interação entre fatores ambientais e genéticos, e entre os fatores genéticos, variantes exônicas de transmissão dominante nos genes LRRK2 (leucine-rich repeat kinase 2), VPS35 (vacuolar protein sorting 35) e EIF4G1 (eukaryotic translation initiation factor 4-gamma 1) têm sido associadas à etiologia da doença. Entretanto, estudos sobre o efeito dessas variantes na população brasileira são raros ou inexistentes. Por essa razão, neste trabalho rastreamos mutações nos genes VPS35 (p.D620N; p.R524W), EIF4G1 (p.R1205H; p.A502V) e LRRK2 (p.G2019S) em uma amostra de 582 pacientes brasileiros com DP não aparentados e 329 indivíduos controles saudáveis. Além disso, conduzimos o primeiro estudo caso-controle para análise de variantes exônicas raras (p.Q1111H, p.T1410M, p.M1646T, p.S1761R, p.Y2189C) e comuns (p.N551K, p.R1398H, p.K1423K) no gene LRRK2 em um subgrupo de 329 pacientes brasileiros com DP, não aparentados, naturais da região sudeste. Esse subgrupo foi analisado e comparado com 222 indivíduos controles saudáveis a fim de verificar associações dessas variantes e a DP. Em relação às mutações dos genes VPS35 e EIF4G1, não foram encontradas alterações nos pacientes com DP. A mutação p.G2019S no gene LRRK2 foi encontrada em 15 probandos (2,6%), dos quais 9 são do sexo feminino (64,3%). O tremor em repouso foi observado em 47,36% dos pacientes com a mutação p.G2019S como primeiro sintoma motor. As análises das variantes raras no gene LRRK2 não revelaram qualquer associação estatisticamente significante. Entre as variantes comuns, a p.K1423K mostrou evidência de associação de risco com a DP (p<0,05) na estratificação contendo o grupo de indivíduos com história familiar da doença e para as variantes p.N551K e p.R1398H não foram observadas associações. A análise do haplótipo p.N551K-p.R1398H-p.K1423K revelou associação de proteção na amostra sudeste e na estratificação Rio de Janeiro (p<0,05). Esse haplótipo não está em desequilíbrio de ligação na amostra de 222 indivíduos controles brasileiros analisados (r2≤45). Os resultados obtidos neste estudo representam contribuições valiosas ao entendimento da relação entre as variantes genéticas estudadas e o risco de desenvolvimento da doença de Parkinson, principalmente no que se refere aos endofenótipos associados.
Parkinsons disease (PD) is the second most common neurodegenerative disorder in the world, affecting 1-2% of population more than 65 years of age, clinically recognized by resting tremor, bradykinesia, postural instability and rigidity. These manifestations occur due to progressive neuronal degeneration and to the presence of protein inclusions enriched with α-synuclein. PD results from the interaction between environmental and genetic factors, and, among genetic factors, dominant exonic variants in LRRK2 (leucine-rich repeat kinase 2), VPS35 (vacuolar protein sorting 35) e EIF4G1 (eukaryotic translation initiation factor 4-gamma 1) genes have been described as causes of the disease. However, studies of the effect of these variants in Brazilian population are rare or do not exist. For this reason, in this study we decided screening mutations in VPS35 (p.D620N; p.R524W), EIF4G1 (p.R1205H; p.A502V) and LRRK2 (p.G2019S) genes in a cohort of 582 unrelated Brazilian patients with PD and 329 healthy individuals control. In additional, we carried on the first case-control study to analyze LRRK2 exonic rare (p.Q1111H, p.T1410M, p.M1646T, p.S1761R, p.Y2189C) and common (p.N551K, p.R1398H, p.K1423K) variants in a subgroup of 329 unrelated Brazilian patients with PD from Southeastern region. This group was analyzed and compared to 222 healthy individuals control in order to verify associations between these variants and PD. Regarding mutations of VPS35 and EIF4G1 genes, we have not found any alteration in Brazilian patients with PD. The mutation p.G2019S in LRRK2 gene was found in 15 probands (2.6%), 9 of them are female (64,3%). Resting tremor was observed in 47,36% of p.G2019S patients as the predominant initial symptom. Regarding the LRRK2 rare variants, the results showed no significant association. Among LRRK2 common variants, the p.K1423K showed evidence of risk association with PD (p<0,05) in the stratified analysis concerning the group of patients with family history of the disease, in contrast, p.N551K and p.R1398H variants showed no associations. The analysis of p.N551K-p.R1398H-p.K1423K revealed protection in Southeastern group and Rio de Janeiro stratification (p<0,05). This haplotype is not in disequilibrium linkage in 222 Brazilian healthy individuals control analyzed (r2≤45). Results obtained in this research represent valuable contributions for the understanding of association between the genetic variants studied and the risk of developing PD, particularly with regard to the associated endophenotypes.
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Ismael, Sazan Khalid. "Mechanisms of Neurodegeneration and Neuroprotection in Parkinson’s and Alzheimer's Disease." Ohio University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1565615884263425.
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Fleming, Pete. "The effects of subthalamic nucleus deep brain stimulation on behaviour and cognition in parkinsons disease." Thesis, University of Sheffield, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.505329.
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Penko, Amanda L. "PHYSICAL ACTIVITY AND SELF-EFFICACY IN INDIVIDUALS WITH PARKINSONS DISEASE WITH A HISTORY OF FALLS." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent1510910099665047.
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Cassella, Sarah N. "Aging, Stress and Inflammation in a Rat Model of Parkinson's Disease." University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1439308521.
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Fernández, Carasa Irene. "Investigating the role of mitochondrial dysfunction in the pathogenesis of Parkinsons´s disease using patient-specific derived astrocytes." Doctoral thesis, Universitat de Barcelona, 2021. http://hdl.handle.net/10803/673716.
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Parkinson’s disease (PD) is an incurable, chronically progressive disorder of old age leading to premature invalidity and death. Clinically, PD is characterized by classical motor syndrome linked to a progressive loss of dopamine-containing neurons (DAn) in the substantia nigra pars compacta, and disabling non-motor symptoms related to extranigral lesions.
The identification of several genes associated to familiar PD have brought considerable insight into underlying pathogenic mechanisms. However, the unknown etiology of the sporadic forms (90% of patients) and the emerging view that non-neuronal cells could be also implicated in the pathophysiology of the disease, greatly impact on the development of accurate models and on the discovery of a cure. Here, I investigate the role of astrocytes in disease pathogenesis using a human iPSC-based model of Parkinson’s disease.
First, I introduce Parkinson’s disease, its pathological hallmarks and the progression of the symptoms, and discuss genetic and environmental influences. Then, I elaborate on the different mechanisms involved in PD including mitochondrial dysfunction, oxidative stress and autophagy as well as on the inflammatory phenotypes observed in the disease and recent work describing the role of inflammation in PD animal models and post-mortem brain tissue.
Subsequently, I examine the association of astrocytic dysfunctions with neuronal morphological and functional abnormalities that contribute to the progression of several neurodegenerative including Parkinson’s disease and the recent data showing an astrocyte-autonomous process mediating PD-associated degeneration of dopaminergic neurons, mainly via intracellular accumulation of α-synuclein aggregates in astrocytes and subsequent propagation of such toxic aggregates to surrounding neurons.
In the results section, I describe the generation and characterization of iPSC- derived astrocytes of LRRK2-PD patients (LRRK2G2019S PD), healthy individual (Ctrl) and CRISPR/Cas9 gene edited isogenic control. I show that LRRK2G2019S PD astrocytes exhibited extensive perinuclear accumulation of fragmented mitochondria and a significant increase in DRP1 phosphorylation compared to control astrocytes. Fragmented mitochondria accumulated in LRRK2G2019S PD astrocytes was due to a defective mitophagy leading to an increase in oxidative stress. I also show that oxygen consumption rate, ATP production and mitochondrial membrane potential were significantly decreased in LRRK2G2019S PD astrocytes indicating altered mitochondrial function in PD astrocytes and that LRRK2G2019S PD astrocytes exhibited lower expression levels of mitochondrial biogenesis-related genes compared to control astrocytes. Importantly, correction of G2019S mutation in the LRRK2 gene by CRISPR-Cas9 gene editing normalized mitochondria morphology, clearance and function to those of control astrocytes. Then, I describe the effects of Urolithin A, a mitophagy activator drug, that was able to rescue mitochondrial fragmentation and accumulation in LRRK2G2019S PD astrocytes by inducing mitophagy, promoting expression of mitochondrial biogenesis-related genes and reducing ROS production in those astrocytes.
Finally, in the last chapter, I show that, in a co-culture system established between LRRK2G2019S PD astrocytes and healthy DA neurons, the treatment with Urolithin A, prevented neuronal cell death, suggesting a potential astrocyte- targeted therapeutic.
In conclusion, our findings provide the advantage for using iPSC-based modeling for assessing the consequences of mitochondrial dysfunctions in astrocytes and dissecting the initial mechanisms that lead to neuronal cell loss in PD. The present modeling has uncovered mitophagy dysfunction as a relevant altered mechanism in PD astrocytes whose activation might represent an interesting therapeutic option for counteracting PD-related neurodegeneration.
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Kudlicka, Aleksandra Katarzyna. "Executive functioning in early stage Parkinson's disease." Thesis, Bangor University, 2013. https://research.bangor.ac.uk/portal/en/theses/executive-functioning-in-early-stage-parkinsons-disease(4985b570-fd51-48ba-8c39-f377b5e2edf0).html.
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Background: Cognitive decline is commonly reported in Parkinson’s disease (PD), with some deficits evident even at the onset of PD. Executive functions (EF) are extensively studied in PD and emerge as the domain involving the most profound deficits. Nevertheless, there are some inconsistencies in the literature with regard to the exact pattern of executive deficits and their impact on everyday life in PD. The aim of the literature review presented in this thesis was to synthesise and clarify existing research evidence on EF in early stage PD, and to explore what are the possible factors affecting the consistency of research findings. The empirical studies had three distinct aims: to clarify the pattern of EF deficits in PD; to determine how accurately PwPD appraise potential EF-related difficulties; and to identify how executive deficits impact on people with PD (PwPD) and their families. Method: Studies of EF in PD were systematically reviewed and the findings were synthesised in a series of meta-analyses. Three empirical studies drew on cross-sectional data collected from PwPD and their caregivers, and from healthy older controls. Sixty-five PwPD in mild to moderate stages of PD completed an assessment of EF, awareness, quality of life, and health status, and 43 healthy older controls completed assessment of EF and awareness. Fifty caregivers of PwPD rated the EF of the PwPD and their own burden associated with caring for a PwPD. A sub-group of 34 PwPD, identified as having potential EF deficits, completed a more extensive neuropsychological assessment of executive abilities. Results: The systematic review included 33 studies of EF in early stage PD, and metaanalysis of data from 5 commonly-used tests of EF revealed consistent evidence for executive deficits. The review suggested that the consistency of the research evidence may be improved by more precision in defining EF and more careful selection and interpretation of EF measures. A data-driven analysis examining the pattern of EF impairment distinguished differences between two groups of standard tests of EF, with attentional control tests more frequently compromised than abstract thinking in early stage PD. PwPD were found to be accurate when making general evaluative judgments about their own functioning, but in specific tasks PwPD with executive deficits overestimated their performance in comparison to PwPD without EF deficits and healthy controls. EF-related behavioural difficulties were shown to impact on subjective quality of life in PwPD and on burden in their caregivers. Conclusions: The results of this thesis suggest that EF-related difficulties are frequently present in early stage PD, with attentional control aspects of EF particularly affected, that it may be difficult for PwPD to accurately appraise their own ability to carry out specific activities, and that EF-related difficulties have a significant impact on quality of life in PwPD and their families. A thorough understanding of executive deficits in PD is important in the provision of adequate person-centred care for PwPD and their family members, and could help to inform the development of PD-specific rehabilitative interventions aimed at reducing activity limitation and restrictions on social participation and supporting PwPD in living well with the condition.
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Hult-Lindkvist, Malin, and Linnea Orrhult. "När hemmet blir en vårdplats : - upplevelse av att vårda en närstående med Parkinsons sjukdom." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-15400.
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Många närstående till en sjuk familjemedlem tar sig an rollen som vårdgivare vilket annars hade antagits av hälso- och sjukvårdspersonal. Nedskärningar inom den offentliga sektorn fortskrider och inte tillräckligt med fokus läggs på hur detta påverkar de närstående som vårdar en sjuk närstående i hemmet. Syftet med litteraturstudien var att beskriva upplevelsen och vad som påverkar upplevelsen av att vara vårdgivare i hemmet till en närstående med Parkinsons sjukdom. Studien utfördes som en litteraturstudie. I resultatet framkom fyra kategorier: Tid och relation, Stöd och information, Sjukdomsförlopp och Symtom. Resultatet visade att vårdgivare upplevde det svårt att ha en normalt fungerande vardag till följd av deras roll som vårdgivare. Vårdgivares upplevda börda ökade även i takt med den närståendes sjukdomsförlopp. En bra relation och mycket ömsesidighet mellan parterna minskade den upplevda bördan hos vårdgivarna samt ökade deras upplevda livskvalitet. Vårdgivare upplevde att stödgrupper minskar deras mentala börda genom att de fick möjlighet att dela med sig av sina erfarenheter till andra och att det hjälpte dem att förstå och själva handskas med sin situation. Vårdgivare upplevde att de inte fick tillräcklig information och stöd från hälso- och sjukvården. Vårdgivare ansåg att den fysiska funktionsnedsättningen var mer påtaglig vid direkt vård och gav mer fysisk påfrestning hos vårdgivaren än vad de psykiska symtomen gjorde. De psykiska symtomen hade större inverkan på vårdgivarens mentala hälsa och deras upplevda börda. Då antalet vårdgivare som vårdar en närstående i hemmet ökar är det av stor vikt att forskning genomförs och uppmärksammas.Many people related to a sick person take on the role of caregiver, which would otherwise have been adopted by healthcare professionals. Cut downs in the public sector are progressing, and there is not enough focus on how this affects the persons who cares for a sick loved one at home. The purpose of this study was to describe the experience of being a caregiver and what factors affects the experience of a caregiver who cares for a loved one at home with Parkinson’s disease. The results revealed four categories: Time and relationship, Support and information, Disease duration and Symptoms. The results showed that caregivers find it difficult to have a normally functioning everyday life due to their role as caregivers. The caregivers perceived burden increases as the loved ones disease processes. A good relationship and a lot of mutuality between the parties reduce the perceived burden among caregivers, and increase their perceived quality of life. Caregivers feel that support groups reduce their mental workload by enabling them to share their experiences with others and that it helps them to understand and cope with their situation. Caregivers feel they do not receive adequate information and support from health care. The caregivers feel that the loved ones physical disability is more pronounced at the direct care and involves more physical stress than the mental symptoms makes. The psychological symptoms have a greater impact on caregivers’ mental health and their perceived burden. As the number of caregivers who care for a loved one at home increases it is of great importance to maintain research and attention to made research.
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Ekvall, Malin, and Jinfei Kotka. "Att leva med Parkinsons sjukdom: hur de drabbade upplever sin livssituation : En studie baserad på självbiografier." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19258.
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Bakgrund: Parkinsons sjukdom är en obotlig sjukdom som ofta drabbar personer i 50–60 års ålder. Sjukdomen finns ofta hos patienten långt innan diagnosen ställs och innebär en livsomställning med både fysiska och psykiska förändringar. I och med att sjukdomen är progreserande försämras livskvalitén ju längre patienten haft sjukdomen. Syfte: Syftet äratt beskriva hur människor med Parkinsons sjukdom upplever sin livssituation. Metod: Enkvalitativ studie som bygger på analys av fem självbiografier skrivna av personer som har drabbats av Parkinsons sjukdom utifrån metoden Att analysera berättelser. Resultat: De drabbade upplever en förändring i sitt liv och sin vardag efter att de diagnostiserats medParkinsons sjukdom. Men trots de utmaningar och svårigheter som upplevs finns en vilja om att fortsätta leva och ta tillvara på tiden. Personerna upplever även en vilja att kämpa för att bibehålla sina fysiska och psykiska funktioner och genom detta bibehålla en god livskvalitet. Konklusion: Personer som drabbas av Parkinsons sjukdom upplever en livsförändring. Men med en positiv livsinställning, stöd från anhöriga, andra personer som lider av Parkinsons sjukdom och sjuksköterska kan de drabbade uppleva en god hälsa trots sjukdomen. Sjuksköterskans kunnighet kring sjukdomen, förmåga att lyssna och sätta sig in i patientens livssituation är viktiga delar för en god vård.Background: Parkinson's disease (PD) is an incurable disease that often begins to affect people in their 50s and 60s. Patients can have different symptoms several years before the diagnosis which affect their well-being. Diagnosis with PD means that a person’s life condition changes both physically and mentally. The patient’s quality of life is seriously affected and gets worse as the time passed due to the disease being progressive. Aim: The aim of the study is to describe how people with Parkinson's disease experience their life.Method: The study is based on a qualitative method “att analysera berättelser” and the data analysis is based on five autobiographies which were written by people suffering from PD. Results: It appears that patients who are living with PD experience a changed ife perspective and situation. Despite the challenges and difficulties in life, there is a willing to continue their life as well as possible and enjoy living in the moment. People also experience a willingness to try to maintain their physical and mental functions and thereby maintain a good quality of life. Conclusion: People who suffers from PD experience a life-changing situation. With a positive attitude and support from relatives and nurses, patients can still experience well-being and have a good quality of life. The nurse's knowledge of PD, ability to listen and understand the patient's life situation are important elements for providing a good care.
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Barbosa, Jeam Haroldo Oliveira. "Quantificação da deposição de ferro no cérebro usando ressonância magnética: um estudo em pacientes com doença de Parkinson." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/59/59135/tde-19092013-142157/.
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A capacidade do ferro, presente no corpo humano, em aceitar e doar elétrons o torna essencial para homeostase celular e várias reações biológicas. Contudo, o excesso deste metal no cérebro pode gerar efeitos deletérios através da produção de espécies reativas de oxigênio que causam o estresse oxidativo. Este estresse aparece como possível causa de doenças neurodegenerativas, caracterizadas por um aumento significativo da concentração de ferro em certas regiões do cérebro. Detectar e quantificar a deposição de ferro in vivo no cérebro torna-se de extrema relevância para entender diversas doenças neurodegenerativas. Neste estudo avaliamos a sensibilidade e a especificidade das principais técnicas de Ressonância Magnética in vivo para estimar o conteúdo de ferro depositado no cérebro. Foram estudados um grupo de 16 sujeitos saudáveis e outro de 14 pacientes com doença de Parkinson. Mapas de relaxometria (R2 e R2*) e susceptibilidade (QSM) foram estimados a partir de imagens adquiridas numa maquina de RM de 3.0T. Embora todos os mapas tenham apresentado correlação linear (r2 = 0; 7) com o acumulo de ferro reportado in vitro nas regiões do núcleo da base, apenas os mapas R2 e QSM apresentaram estatisticamente aumento significativo (p<0,05) para certas regiões do cérebro parkinsoniano (substância negra, núcleo rubro e globo pálido). O mapa QSM apresentou maior sensibilidade e especificidade para diferenciar pacientes com a doença quando comparados a sujeitos saudáveis por meio da análise da curva ROC. Concluímos que os mapas de relaxometria e susceptibilidade magnética podem estimar de forma indireta o conteúdo de ferro no cérebro, apesar de apresentarem dependências diferentes com a concentração deste metal. Observamos também que os valores de sususceptibilidade magnética obtidos com imagens de baixa resolução (1,0x1,0x2,0mm) não apresentaram mudanças significativas em relação aos obtidos com imagens de alta resolução (0,5x0,5x2,0mm). Logo, sugerimos a aquisição de imagens com baixa resolução para o processamento do mapa QSM. A analise de múltiplos valores de tempo de relaxação T2 determinou apenas um valor para cada região do núcleo da base para ambos os grupos, este resultado foi aparentemente afetado pela relação sinal ruído.The capacity of the iron present in the human body to accept and donate electrons makes it essential for cellular homeostasis and various biological reactions. However, an excess of the metal in the brain can produce deleterious effects through the production of reactive oxygen species that cause oxidative stress. This stress can be the possible cause of neurodegenerative diseases which present a significant increase in iron concentration in certain brain regions. To detect and quantify iron deposition in the brain in vivo has high potential for understanding neurodegenerative diseases. In this study we evaluated the sensitivity and specificity of the main Magnetic Resonance technique in vivo to estimate the content of iron deposited in the brain. Were studied a group of 16 controls and 14 patient with Parkinson disease. Relaxometry map (R2 and R2*) and magnetic susceptibility map QSM were estimated by images obtained of scanner of Magnetic Resonance of 3T. Although all maps have presented linear correlation (r2=0.7) with the accumulation of iron reported in vitro regions of basal ganglia, only the R2 and QSM maps showed significant increase (p < 0.05) for certain regions of the parkinsonian brain (substantia nigra, red nucleus, and globus pallidus). The QSM map showed higher sensitivity and especificity for differentiate patients with the disease when compared with controls by the analysis of curve ROC. We conclude that magnetic susceptibility and relaxometry maps may estimate indirect the content of brain iron, although having different dependencies with the concentration of this metal. We also observed that the values of magnetic sususceptibility obtained with low resolution images (1,0 x1, 0x2, 0mm) showed no significant change compared to those obtained with high-resolution images (0,5 x0, 5x2,0mm). So, we suggest the acquisition of images with low resolution to process QSM map. The analysis of multiple relaxation time T2 determined just one value for basal ganglia in both groups, these results were apparently affected by rate noise signal.
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Pikel, Marina Rigolin. "Efeitos de um treinamento de prática mental associada à prática física sobre o desempenho de marcha em pessoas com Doença de Parkinson." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-02102017-154242/.
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A Doença de Parkinson (DP) é uma doença degenerativa do sistema nervoso progressiva e incurável, que causa, entre outras alterações, distúrbios de movimento que levam ao prejuízo de habilidades motoras, em especial da marcha. O uso da prática mental (PM) como um método para aquisição e aperfeiçoamento de habilidades motoras é bem evidenciado na literatura para indivíduos saudáveis e na reabilitação de pessoas pós acidente vascular encefálico (AVE). Porém, ainda há evidências insuficientes da efetividade desse método para a melhora da marcha de indivíduos com DP. Assim, o objetivo deste estudo foi avaliar os efeitos de um treinamento de PM associada à PF guiada por estratégias cognitivas sobre o desempenho de marcha de pessoas com DP. Participaram do estudo 33 indivíduos com DP nos estágios 2 e 3 da Escala Hoehn & Yahr (HY). Eles foram distribuídos aleatoriamente nos grupos experimental (GE: n=17, idade media=62,6 anos, n=10 em estágio 2 e n=7 em estágio 3, segundo HY), que realizou duas sessões do treinamento e controle (GC: n=16, idade media=62,8, n=11 em estágio 2 e n=5 em estágio 3, segundo HY), que não realizou nenhum tipo de treinamento. O treinamento do GE foi composto de 2 sessões, com duração de aproximadamente 60 minutos cada, em uma frequência de uma vez por semana, totalizando 2 semanas. Cada sessão foi subdividida em 5 etapas: conscientização sobre as alterações de marcha decorrentes da DP; familiarização das fases da marcha; memorização das fases da marcha; treinamento isolado da PM em ambiente simples e complexo e treinamento de PM associada à PF da marcha em ambiente simples e complexo. O GC apenas realizou a avaliação de desempenho de marcha em momentos diferentes, que equivalem aos momentos imediatamente, 7 e 14 dias após o término do treinamento do GE. A velocidade média (medida primária) e o número de palavras evocadas durante a tarefa secundária de fluência verbal fonológica e semântica (medida secundária) foram obtidas pelo Teste de Marcha de 30 segundos em condições de tarefa simples e dupla tarefa. Os resultados mostraram que houve uma melhora significativa no desempenho da marcha em termos de velocidade apenas em condições de dupla tarefa para o GE (RM-ANOVA, p<0,05, ES>0,70). Em conclusão, o treinamento proposto que associa a PM a PF da marcha afeta positivamente o desempenho da marcha em condições de tarefa dupla de pessoas em estágios iniciais e intermediários da DPParkinson\'s disease (PD) is a progressive degenerative nervous system disease that causes, among other changes, movement disorders that lead to loss of motor skills, especially in gait. The use of mental practice (MP) as a method for the acquisition and improvement of motor skills is well evidenced in the literature for healthy individuals and stroke patients, but there is still insufficient evidence for the effectiveness of this method in PD gait improvement. Thus, the purpose of this study was to evaluate the effects of MP combined with physical practice (PP) for gait training guided by cognitive strategies in patients with PD. In the procedure, 33 individuals with PD in stages 2 to 3 on Hoehn & Yahr scale (HY) were randomly assigned to experimental group (EG: n = 17, mean age = 62.6 years, n = 10 in stage 2 and n = 7 in stage 3, according to HY), which performed two training sessions, and control group (CG: n = 16, mean age = 62.8, n = 11 in stage 2 and n = 5 in stage 3, according to HY), which did not perform any type of training. The EG training consisted of 2 sessions, 60 minutes each, once per week over 2 weeks. Each session was divided into 5 stages: awareness of gait changes due to PD; familiarization of gait phases; memorization of gait phases; MP training in a simple and complex environment and MP combined with PP training of gait in a simple and complex environment. The CG only carried out gait performance evaluation at different moments, which were equivalent to the moments immediately, 7 and 14 days after the end of EG training. Gait speed (primary outcome) and the number of evoked words during the phonological and semantic verbal fluency secondary gait task (secondary outcome) were obtained by the 30-second Walking Test in single and dual task conditions. The results showed that there was a significant improvement in gait performance for EG in terms of gait speed in dual task conditions only (RM-ANOVA, p<0,05, ES>0,70). In conclusion, the proposed training that associates MP with PP of gait positively affects gait performance under dual task conditions in patients with PD in the early and intermediate stages
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Hattori, Erika Okamoto. "Comparação entre os efeitos do treino motor isolado e do treino motor em condição de tarefa dupla, sobre a marcha e a atenção, em idosos saudáveis e pacientes com doença de Parkinson." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-16022009-153544/.
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A doença de Parkinson (DP) idiopática é uma patologia neurodegenerativa progressiva, caracterizada por sintomas motores como bradicinesia, rigidez muscular, tremor de repouso e instabilidade postural e sintomas não motores como alterações atentivas que influenciam o gerenciamento entre tarefas simultâneas. Mesmo no processo de envelhecimento saudável, há um declínio atentivo. Somando-se a isso, os núcleos da base estão envolvidos com a automatização de movimentos assim, observa-se prejuízo na habilidade de controle dos movimentos automáticos em pacientes com DP com agravamento na execução de tarefas duplas, já que estes passam a despender mais recursos atentivos para tarefas motoras. A habilidade de andar é uma das mais prejudicadas com o surgimento da DP, um comprometimento funcional que interfere no gerenciamento/divisão de recursos atentivos entre outras tarefas que ocorram simultaneamente. Atualmente, o tratamento fisioterapêutico para pacientes com DP prioriza a execução de tarefas motoras isoladas, principalmente quando os pacientes se encontram em estágios moderados e avançados da doença. Este estudo teve por objetivo comparar a eficácia entre dois tipos de treinamento em pacientes com DP e idosos saudáveis. Os grupos foram divididos em dois subgrupos, um deles treinou somente com a repetição extensiva da tarefa motora de alternância de passos e o outro realizou o treinamento na condição de tarefa dupla, ou seja, a tarefa motora associada a uma tarefa auditiva. Para verificar os efeitos do treinamento sobre a tarefa motora foi avaliada a velocidade do movimento e para verificar os efeitos do treinamento sobre a habilidade de gerenciar/dividir a atenção foi analisado o desempenho total, por meio da utilização de um índice, entre a velocidade na tarefa motora e a acurácia na tarefa auditiva. Para verificar se os resultados com o treino em condição de tarefa dupla poderiam ser generalizados para outra condição que exigisse gerenciamento/divisão de atenção, foram aplicados testes psicofísicos de atenção visuoespacial. Os resultados mostraram que a tarefa auditiva não prejudicou o desempenho motor nos grupos que treinaram sob esta condição, independente do tipo de treinamento houve aquisição do aumento da velocidade de movimento.Somente os grupos que treinaram na condição de tarefa dupla apresentaram melhora no desempenho total. Quando analisados os dados do desempenho motor na condição de tarefa dupla observamos que todos os grupos apresentaram melhora no desempenho motor, porém os grupos que treinaram na condição de tarefa dupla, realmente estavam gerenciando/dividindo a atenção, já que o desempenho total também melhorou. Os grupos que treinaram na condição de tarefa motora isolada, quando avaliados na condição de tarefa dupla priorizaram a tarefa motora em detrimento da tarefa auditiva porque na análise do desempenho total a melhora não surgiu. Não foram encontradas evidências de automatização neste estudo. Apenas os grupos que treinaram na condição de tarefa dupla apresentaram melhora no teste psicofísico de atenção visuoespacial dividida.Parkinsons disease (PD) is an idiopathic neurodegenerative disorder featured by motor symptoms as bradykinesia, muscular rigidity, resting tremor and postural instability and by cognitive symptoms as changes in attention that influences tasks simultaneity management. There is an attention deficit even when aging is considered a physiological process. The basal ganglia are involved with the motor learning process and it can be seeing as a lost in automatic motor control when those structures are damage, focusing in the dual-task performance which demands more attention resources. The walking performance is one of the most damaged tasks in the PD, a functional problem that interfere on the management/division of attention sources with another simultaneous tasks. Currently, the physiotherapeutic treatment for patients with PD emphasizes the implementation of single task situations, especially when patients are in moderate and advanced stages of the disease. This study aimed to compare the effectiveness of two types of training in patients with PD and healthy elderly. The groups were divided into two subgroups, one of them trained only with the extensive repetition of the motor task of switching your steps and the other held the training in the dual task condition, motor task associated with hearing task. Movement velocity was used to verify training effects on the motor task and total performance measured by an index calculated between motor task velocities and hearing precision task observed to evaluate motor training and attention effects of competence to observe attentions divided ability. To check whether the results with the training in dual task condition could be generalized to other condition that requires management / division of attention, were applied psychophysical tests of visuospacial attention.Results demonstrated that hearing task couldnt disturb motor performance in groups trained that way. In all condition could be observe enlarged movements velocity. Only dual-task training condition reverts in better performance in total performance, comparing pre and post training conditions. Motor performance improved when analyses of dual-task test condition where done to all groups, but only dual-task training groups where ready to attention divided. Motor task segregated training conditions were evaluated in dual-task conditions when they presented a priority to the motor task and not for the hearing task, knowing when we looked to the total performance measure. No learning automatic tasks were seeing on this study. Only dual-task training groups presented improvement in divided visuo-spatial attention test.
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Siqueira, Camila Silva. "Influência da adrenalectomia bilateral nos eventos neurodegenerativos no modelo do parkinsonismo experimental pela 6-OHDA nigral. Enfoque aos mecanismos parácrinos gliais envolvidos na neuroproteção e cicatrização." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-17122009-084533/.
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Este trabalho tem o objetivo avaliar o efeito da adrenalectomia bilateral no processo neurodegenerativo e cicatricial na via nigro estriatal dopaminérgica lesada pela 6- hidroxidopamina (6-OHDA) em ratos, e deste modo contribuir para a interpretação dos efeitos dos hormônios adreno esteróides nos processos neurodegenerativos e neurotróficos nas lesões do sistema nervoso central. Ratos Wistar adultos jovens foram submetidos à cirurgia de retirada bilateral das glândulas adrenais ou cirurgia simulada para a mesma. Após 2 dias, os animais foram submetidos à cirurgia estereotáxica para lesão do sistema nigro estriatal dopaminérgico através da injeção unilateral de 6-OHDA na substância negra. Os animais receberam diariamente doses de reposição hormonal de corticosterona (10mg/kg) ou solução veículo. Após um período de 72 horas, 1 semana e 3 semanas, os animais foram sacrificados por decapitação, e as regiões do mesencéfalo ventral e corpo estriado foram dissecados bilateralmente. O tecido foi processado para o método de Western blot onde foram analisados os seguintes marcadores: tirosina hidroxilase (TH enzima que participa da via de conversão da dopamina), proteína ácida fibrilar glial (GFAP proteína do filamento intermediário do citoesqueleto do astrócito), bem como as moléculas da matriz extracelular fosfacan, neurocan, sulfato de condroitina e NG2, a proteína Laminina e finalmente, o fator de crescimento fibroblástico-2 (FGF-2) na região do mesencéfalo ventral, onde observa-se ações tróficas nos neurônios dopaminérgicos nigras que podem exercer efeitos no processo inflamatório pelas suas ações gliogênica e angiogênica. Deste modo, a neurodegeneração dopaminérgica foi avaliada pelos níveis da TH, a ativação astrocitária pelos níveis da GFAP, o processo de cicatrização pela regulação das moléculas da matriz extracelular e as respostas tróficas pelo FGF-2. Pelos resultados obtidos é possível que hormônios glicocorticóides adrenais modulem os elementos envolvidos na neurodegeneração e reparo e cicatrização do sistema dopaminérgico.This study has the objective to evaluate the effect of the bilateral adrenalectomy in the neurodegenerative process and cicatrization on the nigroestriatal pathway injury through 6-hydroxydopamine (6-OHDA) in rat, and in this way contribute for the interpretation of the adreno esteroides hormones effects in the neurodegenerative and neurotrophics process in the central nervous system.injury Adult rats wistar were submitted in a surgery to take the bilateral adrenal gland or a simulate surgery of the same. After 2 days the animals was involved into a stereotaxic surgery to nigroestriatal dopaminergic lesion with a unilateral injection of the 6-OHDA in the nigra. The animals received daily corticosterone hormonal (10mg/kg) or vehicle solution. After a period of 72 hours, 1 week and 3 weeks, the animals were decapitated, and the regions of the ventral midbrain and striatum it was bilaterally dissected. The tissue was processed by Western blot method and analyzed for the following markers: tyrosine hydroxylase (TH - enzyme that join of the dopamine conversion pathway), glial fibrilar acid protein (GFAP protein of the intermediary filament of the astrocyte citoesqueleto, the moleculars extracellular matrix phosphacan, neurocan, chondroitin sulfate and NG2, the Laminin protein and finally, the neurotrophic factor (FGF-2) in the region of ventral midbrain, where watched trophic actions in the dopaminergic neurons that could have effects in the inflammatory processes by your gliogenic and angiogenic actions. In this way, the dopaminergic neurodegeneration was evaluated by the TH levels, the astrocytary activation by the GFAP levels, the cicatrization processes by the molecules regulation of the extracellular matrix and the trophics FGF-2 answers. By the results it is possible that adrenal glucocorticoid hormones modulate the elements involved in neurodegeneration, repair and cicatrization of the dopaminergic system.
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Rodrigues, Anelise dos Santos. "Efeitos de um treino de marcha associado à prática mental sobre o desempenho da marcha em pacientes com doença de Parkinson." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-27072018-103214/.
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A doença de Parkinson é uma doença crônica, degenerativa que afeta principalmente funções motora e mentais do indivíduo. Dentre os principais sintomas motores da doença então tremor, rigidez, bradicinesia, instabilidade postural que associados levam a importantes alterações na marcha. A prática mental vem sendo usada como uma estratégia na reabilitação de pacientes com diversas doenças, mas ainda na Doença de Parkinson não temos muitas evidências de sua eficácia. Este estudo tem como objetivo então avaliar o efeito de um protocolo de prática mental associado à prática física no desempenho da marcha de pacientes com Doença de Parkinson. Foram incluídos 20 pacientes nos estágios I, II e III da Escala Modificada de Hoehn e Yahr, que deambulavam sem dispositivos de auxílio, (níveis 3 a 5 da Categoria de Deambulação Funcional FAC), obtinham pontuação maios que 15 pontos na UPDRS e pontuação > 24 pontos no MMSE. O grupo experimental (GE) recebrá uma treinamento de PM da marcha associado a PF, guiado por estratégias cognitiva e o grupo controle (GC) recebeu recebeu um treinamento de PM não relacionada a marcha associada a mesma PF do grupo GE. O desempenho de marcha será avaliado pelo Teste de Caminhada de 6 minutos, UPDRS, Teste de marcha de 30 segundos em condição simples e de dupla tarefa, domínio de marcha da BesTest e a cognição pelo Montreal Cognitive Assessment (MoCA). Foram realizadas 8 sessões de treinamento. Os resultados mostraram que o GE obteve uma melhora significativa maior ao GC na pontuação do BesTest e também no MoCA. Em conclusão, o presente trabalho evidenciou que a adição da PM a um programa de treinamento de prática física tem benefícios no desempenho da marcha e de domínios cognitivosParkinson\'s disease is a chronic, degenerative disease that primarily affects the motor and mental functions of the individual. Among the main motor symptoms of the disease then tremor, stiffness, bradykinesia, postural instability associated with it lead to important gait changes. Mental practice has been used as a strategy in the rehabilitation of patients with various diseases, but we still do not have much evidence of its efficacy in Parkinson\'s disease. The objective of this study was to evaluate the effect of a protocol of mental practice associated with physical practice in the gait performance of patients with Parkinson\'s disease. Twenty patients in stages I, II and III of the Modified Scale of Hoehn and Yahr, who wandered without assistive devices (levels 3 to 5 of the Functional Ambulation Category - FAC), were given a score of 15 points in the UPDRS and scored> 24 points in the MMSE. The experimental group (GE) received MP training associated with PF, guided by cognitive strategies and the control group (CG) received received non-gait PM training associated with the same PF of the GI group. The gait performance will be evaluated by the 6-minute Walk Test, UPDRS, 30-second gait test in single and dual-task conditions, BesTest and the cognition by the Montreal Cognitive Assessment (MoCA). Eight training sessions were held. The results showed that the GE obtained a significant improvement to the GC in the BesTest score and also in the MoCA. In conclusion, the present study showed that the addition of PM to a physical training program has benefits in gait performance and cognitive domains
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Alp, Azad, and Lena Duong. "Sambandet mellan fysisk aktivitet och depression hos personer med Parkinsons sjukdom." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411291.
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Bakgrund: Parkinsons Sjukdom (PS) är en kronisk progressiv neurodegenerativ sjukdom som ger både motoriska och icke-motoriska symtom. Ett vanligt icke-motoriskt symtom vid PS är depression. Depression påverkas, enligt forskning, positivt av fysisk aktivitet (FA) men stark evidens saknas för sambandet mellan dem. Syfte: Syftet med studien var att undersöka sambandet mellan FA och depression hos personer med PS. Metod: Femtioåtta deltagare rekryterades till denna tvärsnittsstudie. The International Physical Activity Questionnaire modified for the elderly (IPAQ-E) användes som mätmetod för FA, och var angiven i form av låg, måttlig och hög fysisk aktivitetsnivå samt i MET-minuter/vecka. Montegomery-Åstrand Depression Rating Scale (MADRS-S) användes för depression och angavs i totalpoäng. Frågeformulärerna sammanställdes till en webbenkät varifrån datan samlades in. Sambandet beräknades med Spearmans rangkorrelation. Resultat: Av samtliga deltagare hade 15 (26%) låg fysisk aktivitetsnivå, 18 (31%) måttlig och 25 (43%) hade hög fysisk aktivitetsnivå. Bland deltagarna hade 15 (26%) ingen depression, 27 (47%) mild, 14 (24%) måttlig och 2 (3%) svår depression. Sambandet mellan låg, måttlig och hög fysisk aktivitetsnivå enligt IPAQ-E och totalpoäng i MADRS-S visade r = -0.2 och p = 0.14. Sambandet mellan MET-minuter/vecka enligt IPAQ-E och totalpoäng i MADRS-S visade r = -0.15 och p = 0.26. Konklusion: Resultaten visade ett svagt negativt samband men sannolikheten att resultatet beror på slumpen är hög. Det krävs fler studier i framtiden för att säkerställa sambandet mellan FA och depression hos personer med PS.Background: Parkinson’s disease (PD) is a chronic progressive neurodegenerative disease with both motor and non-motor symptoms. Depression is a common non-motor symptom in PD. According to research, physical activity (PA) has a positive effect on depression; however, strong evidence supporting the relation between them is lacking. Purpose: The purpose of this study was to examine the relation between PA and depression in patients with PD. Method: Fifty-eight participants were recruited to this cross-sectional study. The International Physical Activity Questionnaire modified for the elderly was used to measure PA, presented in low, moderate and high physical activity levels and MET-minutes/week. Montegomery-Åstrand Depression Rating Scale was used to assess depression and was presented in total score. The questionnaires were formed into a survey from which the data was collected. Spearman’s rank correlation was used to calculate the relation. Results: Among the participants, 15 (26%) had a low level of PA, 18 (31%) moderate and 25 (43%) high level of PA. Further, 15 (26%) were non-depressed, 27 (47%) had mild depression, 14 (24%) moderate and 2 (3%) severe depression. Evaluating the relation using the two different presentations of PA along with depression scores, results showed r= -0.2 (p= 0.26) and r= -0.15 (p= 0.26), respectively. Conclusion: The result showed a weak negative relation, but the probability of the result being due to coincidence is high. To ensure the relation between PA and depression in patients with PD, further studies are needed in the future.
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Loggenberg, Diane. "Negotiating the great divide : theorising a new quality of life framework for people with Parkinsons disease." Thesis, Manchester Metropolitan University, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.426943.
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Gates, Peter. "Development of a model to predict outcomes after dynamic cycling people with Parkinson's disease." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1625846829132496.
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Scudamore, Owen. "Modelling Parkinson's disease with α-synuclein transgenic mice." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/modelling-parkinsons-disease-with-alphasynuclein-transgenic-mice(2c799251-df3c-43f8-8b29-866d06179512).html.
Full textAbstract:
Parkinson's disease is a chronic, progressive, neurodegenerative movement disorder characterised by bradykinesia, tremor at rest, rigidity and postural instability. The pathological hallmark of the malady is a loss of dopaminergic nigrostriatal neurons, coupled with the inclusion of Lewy bodies and Lewy neurites within the axons and processes of remaining neurons. The exact cause of the disorder remains elusive; however, rare inherited forms of the disease have highlighted specific genes involved in pathogenic pathways that could be germane to sporadic cases. alpha-Synuclein is one such gene, wherein mutations and multiplications provoke abnormal folding and aggregation of the protein to induce pathology. The relevance of alpha-synuclein to sporadic Parkinson's disease is strongly supported by the fact that it is the primary component of Lewy bodies. This has prompted the development of numerous transgenic animals based on alpha-synuclein overexpression; however, none of the models to date represents a perfect replicate of the human Parkinsonian pathology. Indeed, the use of different promoters and transgenes in mice has led to various phenotypes coupled with non-specific, non-existent or late-onset neurodegeneration. Since the majority of alpha-synuclein found within aggregates in PD brain is phosphorylated, it has been postulated that this post-translational modification could be the aggravating factor that initiates aggregation; however, phosphorylation could also be a late event, which occurs after alpha-synuclein is sequestered into inclusions, but where it remains accessible by relevant kinases. In the literature, there is contrasting evidence suggesting that phosphorylated alpha-synuclein is either inductive or preventative of aggregation. Therefore I produced two inducible transgenic mice that would overexpress mutant human alpha-synuclein in Purkinje cells to investigate the in vivo affect of alpha-synuclein phosphorylation on aggregation. The two constructs both contained the PD-linked A53T mutation, in addition to either an S87A or an S129A mutation; the substitution of serine with alanine in these constructs blocks phosphorylation occurring at that position. The mice were then aged and characterised on both a behavioural and a histopathological level. Although at present (age: 16 months) neither of the two lines exhibits any obvious alpha-synuclein pathology, they both present with a seizure phenotype and exhibit significantly reduced horizontal and vertical movement than wild-type controls in the Actimot open field. A different theory for the pathogenesis of PD indicates a role for malfunctioning mitochondria and oxidative stress. In a third mutant line, I wanted to assess the impact of increased oxidative stress on alpha-synuclein aggregation in vivo. Therefore I crossed a previously characterised mouse model of PD with a line haplodeficient for SOD2. This gene codes for a mitochondrial enzyme that scavenges free radicals, thus normally protecting the mitochondria from oxidative stress. The pathology of the haplodeficient SOD2 alpha-synuclein mice was compared with that of wt SOD2 alpha-synuclein mice at an age of 16 months using a combination of Western-blot, PK-PET-blot and immunohistochemical techniques. A significant difference was detected between the two lines suggesting that SOD2 deficiency accelerated alpha-synuclein pathology.
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Maia, Fernanda Martins. "Avaliação da geração de palavras, em indivíduos com doença de Parkinson, através de ressonância magnética funcional." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-08122009-182613/.
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INTRODUÇÃO: As alterações cognitivas na doença de Parkinson (DP) têm sido mais estudadas nos últimos anos, porém alterações de linguagem, embora detectadas clinicamente, permanecem pouco exploradas. Neste estudo, avalia-se a capacidade de pacientes com DP de gerar palavras, durante paradigma de ressonância magnética funcional (RMf), comparandose com voluntários sadios. MÉTODOS: Neste estudo, foram incluídos 17 pacientes com doença de Parkinson, em seguimento no ambulatório de Distúrbios do Movimento do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo e 20 voluntários normais, pareados quanto à idade e escolaridade. Todos foram submetidos à avaliação neurológica e neuropsicológica. Cada indivíduo realizou dois exames de RMf, sendo utilizado o paradigma de geração de palavras, constando de 70 letras cada, durante os quais dados comportamentais foram coletados. As imagens foram analisadas com testes não paramétricos e mapas de correlação entre os resultados de RMf e dados comportamentais (percentagem de acertos) foram construídos. RESULTADOS: Os grupos apresentavam perfis neuropsicológicos semelhantes, com diferenças somente em testes que envolviam velocidade motora. Nos indivíduos com DP, observou-se ativação das regiões frontal dorsolateral esquerda, giro do cíngulo anterior, área motora suplementar esquerda e do cerebelo à direita durante a geração de palavras, à semelhança do grupo controle. Na comparação entre grupos, notou-se maior resposta hemodinâmica nos pacientes com DP, em relação aos controles, em áreas do córtex frontal dorsolateral esquerdo. Observouse, ainda, no grupo com DP, menor atividade na porção anterior do cíngulo e área motora suplementar esquerda. Na análise comportamental, incluindo a classificação dos erros, não houve diferenças entre os grupos. Para explicar esses resultados, especula-se que as diferenças nas áreas subcorticais possam estar relacionadas com o aumento da atividade no córtex frontal dorsolateral, uma vez que a degeneração das vias mesolímbicas é descrita na DP, associada com disfunção no circuito dos núcleos da base, provavelmente envolvendo as alças do cíngulo e dorsolateral. Isso significaria uma manobra compensatória, garantindo um desempenho funcional normal nos pacientes com DP. CONCLUSÃO: Ativação do córtex frontal dorsolateral esquerdo, giro do cíngulo anterior, área motora suplementar esquerda e do cerebelo à direita foram observadas nos pacientes com DP durante paradigma de geração de palavras. Maior ativação do córtex frontal dorsolateral esquerdo ocorre nos pacientes com DP e menor atividade foi observada no cíngulo anterior e área motora suplementar esquerda, quando comparados a voluntários normais, durante paradigma de geração de palavras.Cognitive disturbances have been studied in patients with Parkinson´s disease (PD) in the last years but language dysfunction, although observed in clinical practice, are just now being explored. In this study, we investigate PD patients ability to generate words using a functional magnetic resonance (fRMI) paradigm and compare these areas with healthy volunteers. We selected 17 PD patients from the Movement Disorders Clinics of Hospital das Clinicas, Universidade de São Paulo and 20 healthy volunteers, matched for age and years of formal education. Both groups were evaluated from neurological and neurophsychological perspective and showed similar profiles, with differences only in tests that involved motor speed. Each subject was scanned twice using an overt-speech block design fRMI paradigm with visual presentation of 70 stimuli during which behavioral data were collected. Images were analyzed using a non-parametric approach, and correlation maps between fRMI results and behavioral data (percentage of correct responses) were produced. PD patients showed activity on the left dorsolateral frontal cortex, anterior cingulate gyrus, motor supplementary areas and right cerebellum during the word generation paradigm, similar to the healthy volunteers group. PD patients had increased hemodynamic response in the left dorsolateral frontal cortex and a reduction was found at anterior cingulated gyrus and motor supplementary area compared to healthy volunteers. Behavioral analyses (including error classification) did not show any differences between groups. We speculate that the difference found in subcortical areas may be related to the increment observed in the frontal dorsolateral cortex, since degeneration of mesolimbic dopaminergic pathways is described in PD associated with dysfunction on basal ganglia circuitry, especially involving the cingulated and dorsolateral loop. A possible mechanism involves a compensatory maneuver, in a way to maintain a normal functional performance in PD patients. In conclusion, we observed the activation on the left dorsolateral frontal cortex, anterior cingulated gyrus, motor supplementary areas and right cerebellum during the word generation paradigm in PD patients. These patients had greater cortical activity on the left dorsolateral frontal cortex and less activity on the anterior portion of the cingulated gyrus and motor supplementary area when compared to normal controls.